DIPLOME EN OSTEOPATHIE (D.O.) · and its role in our work. Subject material in the fields of...

Année 2015

Pour le

DIPLOME EN OSTEOPATHIE (D.O.)

Présenté et soutenu publiquement

Le 15 juin 2015

À Montréal

Par

DELANGE, CARLA

Né le 5 Septembre 1961, Bowmanville, Canada

Membres du jury

Président : VOYER, Guy, Pht MD DO

Assesseurs : MICHEL, Daniel, MD DO

BURKE, Andy, MSc Sport Medicine DO

SANDERSON, Eric, DO

MARIN, Karyne, DO

FONTAINE, Luc, DO

Directeur du mémoire : SIMMS, Marg, DO

THE ROLE OF “WATER” IN THE BODY

and the Relevance to Osteopathic Treatment

ii

Pre-Reader: Gordon Lowe

iii

Abstract

The fluid in the body was of obvious importance to AT Still; and in Osteopathy, this importance

is often discussed. But do we really understand the relevance and nature of these fluids? This is a

very large subject to study, but as I practice, I have more questions, as well as respect for the

power of fluids. For the purpose of this paper, I will often refer to all the fluids as “water”, as it is

the basis of the fluids, being the solvent for the various solutes.

Biodynamic fluid, extracellular fluid, extracellular matrix fascia and to a lesser extent lymphatics

are all complex topics. But what are the basic characteristics of these fluids?

Water has been studied by many researchers, in both microscopic and macroscopic detail. It is a

study that could last several lifetimes. The amount of research currently being done in

biomedical engineering alone is not possible to fully read without getting progressively more

behind. This paper will attempt to give a thorough explanation of the role and movement of

water in the body in relation to topics important for Osteopathic work. The most relevant work

will be discussed and its applicability to the Osteopath in daily practice. I wish to simplify the

complexity of the topic, but maintain respect for the great complexity of this important molecule

and its role in our work.

Subject material in the fields of biomedical research, biochemistry, bioengineering, engineering,

biomechanics, and complex systems analysis were read from the perspective of traditional

osteopathic philosophy and practice.

To fully utilize the biochemistry and the nature of molecules would improve the results of an

Osteopathic practitioner, and an understanding of at least the basics will be helpful in practice.

iv

Résumé

A.T. Still accordait beaucoup d’importance aux fluides du corps humain, et ce sujet est souvent

abordé en ostéopathie. Mais comprenons-nous réellement la pertinence et la nature de ces

fluides? En faire l’étude est un sujet très vaste, et plus j’avance dans ma pratique, plus je me

questionne sur les fluides et plus je respecte leur puissance. Pour les besoins de cet exposé, je

ferai souvent référence à tous les fluides en les appelant « eau », puisque l’eau est la base des

fluides, étant le solvant de plusieurs solutés.

Les fluides biodynamiques, les fluides extracellulaires, la matrice fasciale extracellulaire et, dans

une moindre mesure, les lymphatiques sont tous des sujets de grand complexité. Mais quelles

sont les caractéristiques de base des fluides? L’étude de l’eau a été abordée par un grand nombre

de chercheurs de façon détaillée, tant au niveau microscopique que macroscopique, et ces études

pourraient se poursuivre pour les siècles à venir. Vu le très grand nombre de projets de recherche

actuellement en cours ne concernant que l’ingénierie biomédicale, il est quasi impossible d’en

faire la lecture sans prendre un retard qui s’accentuerait progressivement et ne se rattraperait

jamais. Cet exposé tentera d’apporter une explication exhaustive du rôle et du mouvement de

l’eau dans le corps, en lien avec des thèmes qui sont importants pour le travail ostéopathique. Les

travaux les plus pertinents seront abordés, ainsi que leurs applications par l’ostéopathe dans sa

pratique quotidienne. J’ai le désir de simplifier la complexité de ce sujet tout en respectant la

grande complexité de cette molécule et son rôle dans notre travail.

C’est sous l’angle de la philosophie et de la pratique de l’ostéopathie traditionnelle que s’est fait

la lecture de documents traitant de recherche biomédicale, de biochimie, de bio-ingénierie,

d’ingénierie, de biomécanique et d’analyse de systèmes complexes.

La biochimie ainsi que la nature des molécules sont d’une importance capitale en ostéopathie, et

la compréhension à tout le moins de leurs bases sera d’un support précieux dans notre pratique.

v

Acknowledgements

This project would not have been possible without the support and assistance of many people.

Firstly, my gratitude to Guy Voyer, D.O., for his stimulating my interest in pursuing a second

Osteopathic program. His vast knowledge and enthusiasm for his subject is an inspiration. I

would not have undertaken this memoire otherwise. Thank you, also, to Daniel Michel who has a

gifted way of making Osteopathy logical and applicable to medicine. Thank you to Max Giardin,

who has such a way of making things make sense, that he inspired this choice of topic.

My sincerest thanks to Marg Simms; who has in turn has become my thesis advisor. Our

conversations on Osteopathy and the body, and all the amazing things we see if our work have

provided great stimulus in my thinking. In addition to advising me, and encouraging such a topic,

you provided support and friendship on many other levels. Thank you.

Thanks also to the multitude of other teachers over the years, who have all given their

interpretations of Osteopathy, and enabled me to work at drawing parallels in many different

viewpoints.

Thank you to my students, for your questions, which inspire me to keep “Digging On”. And to

all of my lateral thinking colleagues: thank you for getting excited when I find more “water

tangents”.

And lastly but not least, a big thanks to my family and friends, who have had to be patient with

my time constraints for far too long.

vi

Table of Contents

Abstract .......................................................................................................................................... iii

Résumé ........................................................................................................................................... iv

Acknowledgements ......................................................................................................................... v

Table of Contents ........................................................................................................................... vi

Overview of Format ........................................................................................................................ x

List of Figures and Illustrations .................................................................................................... xii

List of Abbreviations ................................................................................................................... xiv

Disclaimer ..................................................................................................................................... xv

1. INTRODUCTION ...................................................................................................................... 1

1.1 Thoughts ............................................................................................................................. 1

1.2 Motivation for the Research ................................................................................................ 2

1.3 Overview of Thesis ............................................................................................................. 3

2. METHODOLOGY ..................................................................................................................... 4

2.1 Research Questions ............................................................................................................. 4

2.2 Research Design .................................................................................................................. 4

3. COMPLEXITY ........................................................................................................................... 6

3.1 Studying Complexity: General Systems Theory................................................................. 6

3.2 Complexity in Biological Systems ................................................................................... 7

3.3 Complexity in Osteopathy ................................................................................................ 8

3.4 Research Standards ........................................................................................................... 10

4. THE STRUCTURE OF WATER ............................................................................................. 11

4.1 The Water Molecule – Chemistry ..................................................................................... 11

4.2 Water as a Net ................................................................................................................ 15

4.3 Water as a Polar Substance ............................................................................................ 17

vii

5 WATER AS A SOLUTE AND SOLVENT ..................................................................... 18

5.1 WATER AS A SOLUTE .................................................................................................. 18

5.1.1 Polar Solvent Properties .......................................................................................... 18

5.1.2 Reactivity of Water ................................................................................................. 19

5.1.3 Water as a Protector ................................................................................................ 20

5.2 General Fluids in the body ................................................................................................ 20

5.2.1 Intracellular Fluid .................................................................................................... 20

5.2.2 Extracellular Fluid (ECF) ....................................................................................... 21

5.3 Extra- Cellular Matrix/Interstitial Fluid/Extra-Cellular Fluid (for convention) ............. 22

5.4 Cerebral Spinal Fluid (CSF) ............................................................................................. 31

5.5 Lymphatic Fluid ............................................................................................................. 36

5.6 Blood .............................................................................................................................. 38

Osteopathic Relevance .......................................................................................................... 38

5.7 Synovial Fluid ................................................................................................................ 39

6. WATER AND CELLULAR STRUCTURE ............................................................................ 41

6.1 Cell Membranes ................................................................................................................ 41

6.2 Water Movement Through Cell Membranes .................................................................... 43

6.2.1 Simple Fluid Absorption ......................................................................................... 45

6.2.2 A Standing Gradient of Fluid Flow (via Aquaporins) ............................................ 45

6.3 Embryological Considerations .......................................................................................... 47

7. FLUID FLOW .......................................................................................................................... 52

7.1 General .............................................................................................................................. 52

7.2 Vascular Circulation in the Human Body (in vivo) .......................................................... 53

7.3 Cancer ............................................................................................................................... 58

7.4 Pressure Gradient .............................................................................................................. 58

viii

7.5 Mesenchymal Stem Cells .................................................................................................. 58

8. DRAINAGE OF FLUIDS - LYMPHATICS & GLYMPHATICS .......................................... 61

8.1 Lymphatics ........................................................................................................................ 61

8.2 Glymphatics ...................................................................................................................... 64

9. TISSUE QUALITIES ............................................................................................................... 71

9.1 Images Under the Skin ...................................................................................................... 71

9.2 Hydration .......................................................................................................................... 73

9.3 Cation pumps .................................................................................................................... 75

10. WATER AND ENERGY ....................................................................................................... 77

10.1 Thixotropy ...................................................................................................................... 77

10.2 Electromagnetics ............................................................................................................ 78

10.3 Energy Medicine ............................................................................................................ 80

10.3.1 Laying on of hands ................................................................................................. 80

10.4 Fluids in homeopathics................................................................................................... 82

10.5 Infrasound ....................................................................................................................... 86

11. OTHER ASPECTS ABOUT WATER STRUCTURE ........................................................... 91

11.1 Dr Emoto - Images of water crystals .............................................................................. 91

11.2 Cluster Water .................................................................................................................. 94

11.3 Aging .............................................................................................................................. 96

12. DISCUSSION AND CONCLUSION..................................................................................... 97

12.1 Discussion ...................................................................................................................... 97

Case Study of Patient with Pheochromocytoma and Takotsubo Cardiomyopathy .............. 103

12.2 CONCLUSION ............................................................................................................ 104

BIBLIOGRAPHY ....................................................................................................................... 105

GLOSSARY ............................................................................................................................... 112

ix

Appendix 1 Hydrodynamics ............................................................................................. 118

Appendix 2 FLOW ........................................................................................................... 120

Appendix 3 Introduction to Complexity ........................................................................... 124

Appendix 4 About Water Filtration in the Home .............................................................. 125

Appendix 5 MRI Scans of a paralyzed patient .................................................................. 130

Appendix 6 Takotsubo cardiomyopathy ........................................................................... 134

Appendix7 Tau Pathology ................................................................................................ 138

Appendix 8 Chlorine and your shower.............................................................................. 139

Appendix 9 Balneotherapy ................................................................................................ 143

Appendix 10 Emoto Water Crystals ..................................................................................... 146

Appendix 11 The VAS and Auricular Medicine ............................................................... 148

x

Overview of Format

Chapter 1 is an introduction to the concept of water as the basis of life, and Still quotes as well

as water/fluid in the body

Chapter 2 is a description of the methodology used in qualitative research.

Chapter 3 establishes the context of the paper within the paradigm of complexity and complex

systems theory.

Chapter 4 concerns the structure of water, H2O

Chapter 5 discusses water as a solute and solvent, and discusses the types of water/fluid in the

body and their compositions,

Chapter 6 discusses the role of water in cellular structure, also the role of fluid movement in

terms of embryologic development – flow first then veins then arteries, heart from folding.

Chapter 7 is an overview of fluid flow –laminar, turbulent, reversing (small reversed pulsation),

and discusses flow in the body – types of flow – general, types of fluid, types of flow specifically

in the body as well as some effects of flow

Chapter 8 discusses the lymphatics, glymphatics.

Chapter 9 discusses tissue qualities related to water- hydration of tissue and also the research

of French surgeon J.C. Guimberteau and his in vivo observations of the ECM

Chapter 10 discusses water and energy, including energy medicine, fluid with homeopathics

Chapter 11 discusses structured water, looks at factors in change of shape, and phase

(exclusion zone water, water clusters), water tides and the moon

Chapter 12 is a summary and discussion of the findings, with an emphasis on osteopathic

concepts and practice, including volumetric treatment and fascia work, venous pumping and

xi

venous sinus work, as well as a case study of an interesting fluid patient – the result of

pheochromocytosis and “adrenalin storm” with paralysis and finally the conclusion

Glossary

Bibliography

Appendices :

xii

List of Figures and Illustrations

Figure 1 Hydrogen molecule ........................................................................................................ 11

Figure 2 Oxygen molecule a) periodic table b) 3-dimensional representation .......................... 12

Figure 3 Hydrogen, Oxygen, Water .............................................................................................. 12

Figure 4 Model of Water Molecule .............................................................................................. 14

Figure 5 When Hydrogen has the electrons. When Oxygen has the electrons. ....................... 14

Figure 6 Three phases of water ..................................................................................................... 15

Figure 7 Aligning water molecules ............................................................................................... 16

Figure 8 Beginning of a network of water. ................................................................................... 16

Figure 9 Crystalline lattice of water in solid state. ....................................................................... 16

Figure 10Density of water molecules ........................................................................................... 16

Figure 11 Water pulling the stronger ionic bonds. ....................................................................... 17

Figure 12 Hydrolysis and dehydration synthesis of Disaccharides .............................................. 19

Figure 13 Proteoglycan structure .................................................................................................. 23

Figure 14 Fibroblast ...................................................................................................................... 23

Figure 15 Enlargement of Figure 15 ............................................................................................. 24

Figure 16 Alpha helix and Beta folding structures. ...................................................................... 24

Figure 17 Demonstrating lattice in the coil for water binding –Oschman ppt .............................. 25

Figure 18 α-helix peptide chain .................................................................................................... 26

Figure 19 Non-mixing of Baltic Sea/North Sea and Alaskan oceans ........................................... 28

Figure 20 Running together of the Amazon and Rio Negro without mixing .............................. 29

Figure 21 CSF flow and Choroid Plexus ...................................................................................... 33

Figure 22 The Ground Regulation System from Pischinger ......................................................... 37

Figure 23 Electrolyte composition of blood plasma, ISF and ICF ............................................... 39

Figure 24 Schematic of Polar Phospholipid.................................................................................. 41

Figure 25 The beginning of a cell before “evolution” and life ..................................................... 42

Figure 26 Schematic of an Aquapore 1 ......................................................................................... 43

Figure 27 Functional Schematic ofAQP1 ..................................................................................... 43

Figure 28 Schematic of water movement across cell membrane .................................................. 44

xiii

Figure 29 Schematic with osmosis and aquaporin ........................................................................ 44

Figure 30 Schematic ofsimple water pore .................................................................................... 46

Figure 31 Schematic of simple aquapore with 2 α-helices showing ............................................. 46

Figure 32 Day 5 - Expanded Blastocyst ....................................................................................... 48

Figure 33 Mesenchymal Stem Cell on blood vessel ..................................................................... 59

Figure 34 Pressure gradient in lymph collection .......................................................................... 62

Figure 35 Schematic of lymph node with afferent and efferent vessels. ...................................... 62

Figure 36 Lymph capillaries in the capillary bed ......................................................................... 63

Figure 37 The CSFandits traffic to the lymphatic system ............................................................ 65

Figure 38 Schematic from Paravascular Pathway article ............................................................. 66

Figure 39 Pathway of tracer influx in brain. ................................................................................. 67

Figure 40 Microvacuoles in the MVCAs ...................................................................................... 72

Figure 41 “Wet”collagen network. ............................................................................................... 72

Figure 42 Water droplets formed from destruction. ..................................................................... 72

Figure 43 The underlying network of connectivity. ..................................................................... 72

Figure 44 Water exposed to the word Love .................................................................................. 92

Figure 45 Water exposed to the words You are Beautiful. ........................................................... 92

Figure 46 Comparison of effects of healing music and hurtful emotion. ..................................... 92

xiv

List of Abbreviations

AQP : Aquaporin

BGM : Biological growth method

CSF : Cerebrospinal Fluid

ECF : Extracellular Fluid

ECM : Extra-cellular matrix

GOT : General osteopathic treatment

GST : General systems theory

ICF : Intracellular Fluid

ISF : Interstitial fluid

PCM : Peri-cellular matrix

PRM : Primary respiratory mechanism

Words printed in bold italics (first use only) in the body of the text are defined in the Glossary.

xv

"Water is the driving force of all nature." - Leonardo da Vinci

Disclaimer

This paper is not intended to be a physiology textbook. If more detail is desired,

the reader is invited to pick up any physiology textbook or read some of the articles

in the bibliography. The basics of the water molecule are discussed in some detail

but the main purpose of this is to make the Osteopathic reader think in more detail

of the work they are doing with their hands and how to best influence the body

while their attention is on the fluids.

1 CHAPTER 1: INTRODUCTION

1. INTRODUCTION

1.1 Thoughts

You cannot step in the same river twice, for the second time it is not the same river.

Heraclitus (535-475 B.C.)

Water is life’s mater and matrix, mother and medium. There is no life without water”

Albert Szent-Gyorgyi - Nobel Prize winner 1937

“For nature is in the same genus as potency; for it is a principle of movement – not however in

something else but the thing itself.” - Aristotle - Metaphysica p.1049

"Every drop knows the tide"- W.G. Sutherland, DO

Arteries

“In the year 1854 I proclaimed that a disturbed artery marked the beginning to an hour and a

minute when disease began to sow its seeds of destruction in the human body. That in no case

could it be done without a broken or suspended current of arterial blood, which by nature was

intended to supply and nourish all nerves, ligaments, muscles, skin, bones, and the artery itself.

He who wishes to successfully solve the problem of disease or deformities of any kind in all cases

without exception would find one or more obstruction in some artery, or some of its branches.” 1

1 AT Still, Autobiography, 1908 p 182.1


1.2 Motivation for the Research

The fluid was of obvious importance to AT Still. In Osteopathy, we speak of this importance

often. But do we really understand the relevance and nature of this fluid? It is a very large subject

to study, but as I practice, I have more and more questions and respect for the power of fluids.

Osteopathic treatment is as variable as the number of practitioners. Treatment can range from

firm structural work, to very subtle techniques. The Osteopath listens to the patient’s body at

many different levels, directing the therapeutic force to the level most in need of intervention

and/or attention.

This work depends on the needs of the patient, the interpretation of these needs by the

practitioner, and on the state that day of the patient, who is an ever-changing environment. This

changing environment is due to atmospheric, hormonal and emotional forces among others.

Water is involved in all of these factors. The relevance and methods to best treat using the

characteristics of water will be discussed.

For the purpose of this paper, I will occasionally refer to all the fluids as “water” as it is the basis

of the fluids being the solvent.

What do we really understand of the biochemistry of water, and of its specific actions? The goal

of this paper is to make an exploration of the broad topic of water in search for some useful

insights to improve Osteopathic work.


1.3 Overview of Thesis

The biochemistry of water and its structure is the basis for this work. From this viewpoint,

various fluids of the body are examined. The movement of these fluids is examined in respect to

their biochemical and physical properties, with a later discussion on the relevance to Osteopathic

treatment.

The study of water has been undertaken by countless researchers, in great detail (both

microscopically and macroscopically), and a complete review of the ever increasing body of

detailed information could last several lifetimes. The amount of research currently being done in

biomedical engineering alone is not possible to fully read without getting progressively more

behind. The study of the chemical interactions and metabolites within the fluids of the body is

very complex. This thesis will take a small step towards deepening our understanding of water,

and to give the Osteopathic knowledge. It will touch on some of the most relevant work and

understanding to give the Osteopathic profession an interesting basis for thinking about the role

of fluid in the body.

4 CHAPTER 2: METHODOLOGY

2. METHODOLOGY

2.1 Research Questions

The primary question is:

How do we best utilize the substance that is the greatest component in our body in our

Osteopathic work?

The secondary question is:

How can we better understand the biochemistry of the fluids of the body as well as the

biophysical properties?

2.2 Research Design

Qualitative research has many definitions. It is research that gives detailed descriptions and

explanations of the phenomenon studied rather than providing and analyzing, and has data-

gathering techniques that are focused on the significance of observations made in a study rather

than the raw numbers themselves. It gathers information that can be compared and cross-

referenced to other information, in order to get a new picture. It is a process of “noticing,

collecting, and thinking about interesting things.”i2

To have a better understanding of the function and action of water in the body, relevant to

Osteopathic care required an extensive search in a variety of fields, chemistry, biology,

embryology, engineering, physics, mathematics, Osteopathy, energy work, and philosophy. A

2 Seidel, J V. Qualitative Data Analysis 1998, Qualis Research.

5 CHAPTER 2: METHODOLOGY

literature search was undertaken to review relevant research in order to achieve a better global

understanding of the role of the body fluids, in order to enhance Osteopathic treatment.

A Maximum Variation Sampling strategy was used. Multiple data sources and methods of

research gathering were used. A search on the Queen’s University and the University of Toronto

science and medical library data base was undertaken, and these references were used to direct

attention to other publications. An extensive number of books on biomedical and biochemistry

were read, as well as many medical and complementary medical books. Course notes were used

from Osteopathic courses taken by the author. A good overview of the extra and intracellular

make-up of water was extracted from course material from Belgium Osteopath and EVOST

fellow Max Giardin.

This information was then used to make cross references or Triangulation to the Osteopathic

methodology, as taught in various courses, aligning this information with embryology and

different Osteopathic philosophies, as well as clinical practice. 3

Clinical observations are categorized as anecdotal based practice methodology, in opposition to

the now popular but controversial evidence based practice. This was used to review the relevance

of the data to the work of the Osteopath in clinical practice.

3 Crabtree and Miller, Doing Qualitative Research, 2nd ed 1999, p 39

6 CHAPTER 3: COMPLEXITY

3. COMPLEXITY

3.1 Studying Complexity: General Systems Theory

The Law Of Integrated Wholes

When we try to pick up anything by itself we find it is attached to everything in the universe.

John Muir Electromagnetics

A leader in the field of General Systems Theory (GST), Ludwig von Bertalanffy, developed the

basis of system theory in the late 1920s. His goal was to unite metabolism, growth and

morphogenesis and sense physiology into a dynamic theory of stationary open systems showing a

self-organized dynamics in biological systems. In the late 1940s he realized that this Systems

view could be extrapolated to other generalized systems, regardless of their particular ilk. In this

systems view, the basic concept is that one cannot compute the behaviour of the whole from the

behaviour of the parts.

The multitude of interacting atoms, molecules, cells, tissues, organs, systems are valued by the

complexity of their relationships within the organism, not by their individual expression alone.

This is not meant to be a single all-encompassing theory of everything. It is meant as a systems-

theory, engaged with systemic phenomena. While some people may find this oversimplification,

Ervin Lazlo stated in a collection of essays published in Von Bertalanffy’s honour :

“If this be considered not enough, the reader would do well to remember that a true

general theory of all such varieties of systems would constitute a master science that would make

Einstein’s attempt at a unified field theory pale by comparison.”4

The difficulties that present in discussing the human body and it’s functioning in a General

Systems Theory are many. For example, consider the dynamics of the heart tissue. The

extensibility of the wall would break down if the function as merely the product of the neural,

endothelial and muscle cells. The complexity of the emergent behaviour is too great to be

4 Deisboeck, TS, Kresh, JY (Eds) (2006) Complex Systems Science in Biomedicine. p6


ignored. As Linus Pauling said “Life is a relationship among molecules and not a property of

any molecule” 5

Systems theory is a contruct for building models, a coherent framework for studying multilevel

systems and their relational interaction, in order to enable us to understand complex biological

organization. As Osteopaths, we need to always keep this in mind as we work. The patient is not

just a collection of tissues, upon which we work and attempt to “normalize”. They are a complex

functioning biological entity. We must continually listen and interact in order to work in the same

complexity model.6

3.2 Complexity in Biological Systems

Science concerns itself with credibility. What are the probabilities of something occurring? What

are the measurable facts? Then measurements need to be interpreted and analyzed. They also

need to be repeated to assure that they are reproducible.

But, we know that the whole is more than the sum of the parts. The sum of the parts: that is

measurable. But the more – how do we measure that?

1 +1 = 1 + 1 + the emergent behaviour, therefore = 3.

Or 1 + 1 = 1

So, the measurements need to be the right measurements. And the conclusion from the

measurements must be carefully considered. Is it the macroscopic measurement that is valid from

the emergent behaviour, or a microscopic measurement?

In the science of Complexity, Scientific Methods are adapted to a more holistic view.

When function is discussed, what is function? Is it a judgement, or a true function? We are better

to discuss behaviour.

Form = Structure + Behaviour

5 Ibid p 21 6 Ibid p 20


↓ ↓

Thus, 1 +1 = 1 (system) 1 + 1 = 3

When we have 1+1=1, the resultant 1 is a changed one, with a changed complexity and changed

behaviour. But the link, the + , must be stable or the system is weak. 7

In the constantly changing environment that is the human body, the Osteopath must always be re-

evaluating the changes. A problem evolves, improves, or worsens depending on many factors in a

patient’s life. The emergent behaviour is always changing.

3.3 Complexity in Osteopathy

The books of AT Still are small, but rich in philosophy. There are about 1000 pages in total. In

these pages, he speaks of form 907 times. But how often does he speak of lesions? He spoke of

them only a very few times. It is the despair of many researchers into his life that he did not pass

on his techniques in his writings. But, what did he stress? - Anatomy, health, normal, harmony,

and form. For Still, structure and function can’t be separated; it is one unit - therefore FORM.

The functional complexity of the body is inter-relational, based on systems that link both

anatomically and functionally, guided by hormones and neural, chemical and mechanical

feedback loops, fed and cleansed by fluids. The Osteopath must first determine where to work. Is

it a local tissue problem, a systemic problem, a cellular problem? Where are the links?

Guy Voyer, the founder of Académie Sutherland, compared Complexity to Complication, the

more linear Cartesian method of looking at health.

Instead of looking at cause, we must look at the body as an interactive system. A process, not a

procedure. Instead of the textbooks telling us a problem is such and such, being dialectic, we

must dialogue with the patient to see the bigger picture. Instead of only analyzing the issues, we

must find meaning in the collectivity of symptoms and systems involved, and the other factors in

the patient’s life. Instead of only definition, we look for emergent behaviour.

7 Max Girardin Course notes


It is the job of the Osteopath to normalize dysfunctions respecting the complexity of the human

body. The body is in a constant state of flux, attempting to maintain homeostasis by adapting to

external stimuli and internal actions. These, in turn, are affected externally by societal and

social/familial interactions. The interconnectedness between the internal and external

environments is complex.

How are we as practitioners best able to fully respect the functional organization of the body with

respect to everything that is happening to it. As treatment progresses, it naturally evolves as

changes emerge. This is complexity.

“The functional organization of the body is inter-relational, based on a networks of nerves and

vessels, soft and boney tissues, fluids functioning together by means of a variety of mechanical,

electrical, and chemical feedback mechanisms.

The human body is adaptive: a non-linear, mobile, and non-equilibrium machine that allows a

wide variety of functions to be performed despite large variations of outside conditions.

Complexity of structure creates a highly functional machine that is also compact and efficient,

with information conveyed via feedback loops, providing regulatory controls to the system.”8

Mitchell Feigenbaum, a mathematical physicist who studied chaos theory, stated that we:

“are at the very beginning of (being able) to employ physics, to employ analytical thoughts in

the understanding of biology... When you look at a cell, the first thing a cell does is to use up all

the physics we know as fast as possible. What a cell does is to use physics to build machines, and

thereafter it has no interest in the laws of physics, it has made itself something different."9

In short, there has been a revolution in the way we study biology.

8 Simms M Thesis on Evolving Concepts in Biomechanics 2012 p8 9 ed. Infeld et al, Nonlinear Dynamics, Chaotic and Complex Systems, 1997, p. 321


3.4 Research Standards

In science, usually standard research is experimental, statistical and linear. In a complexity

model, this is not the ideal method for studying complex systems.

In General Systems Theory, two methodologies are used for analysis:10

Time series analysis – this is a mixture of traditional measurements and statistical methods within

a non-linear time series, used to model the underlying dynamics of a system which it tries to

reconstruct. This is therefore a mix of evidence-based practice and a more lateral thinking

method.

Agent based models – in this methodology, individual behaviours, interactions and emergent

behaviours are observed, rather than populations and that is used to gain information about the

collective dynamics of the system. This can be equated to anecdotal-based practice.

This is a methodology that is well suited to the thinking of Osteopathic Practitioners, but the main

body of medicine is still in the linear evidence-based practice mode as evidenced by topics in

conferences, promoting just that.

10

Deisboeck, TS, & Kresh, J.Y. (Eds) (2006) Complex Systems Science in Biomedicine. Part II Chapt 1

11 CHAPTER 4: THE STRUCTURE OF WATER

4. THE STRUCTURE OF WATER

Water is the most abundant and critical inorganic compound in living material. It makes up

between 60 to 80 percent of the volume of most living cells, and in popular literature, it is

described as making up 60 – 80 percent of our body weight. It is also actually 99 percent of our

molecules by number.11

Water is the major transportation medium in living things because it is such an important solvent.

4.1 The Water Molecule – Chemistry

Water is made up of Hydrogen and Oxygen, H2O. It exists in 3 forms (a fourth is argued in some

research- more on that later) as we all learn early in school: liquid, solid and vapour.

Hydrogen has a molecular weight of 1. The electrically neutral form has a

single positively charged proton and a single negatively charged electron

bound to the nucleus by Coulomb force. Atomic hydrogen makes up

approximately 75% of the elemental mass of the universe.

Oxygen has a molecular weight of 16, having 8 protons, 8 neutrons

and 8 electrons, the latter of which are of negligible weight in

terms of the periodic table. By mass, oxygen is the third most abundant element in the universe,

after hydrogen and helium.

11

Pollack, Gerald (2013) The Fourth Phase of Water – Beyond Solid Liquid Vapor p3

Figure 1 Hydrogen molecule


a) b)

Figure 2 Oxygen molecule a) periodic table b) 3-dimensional representation

Oxygen readily binds to other atoms, due to its double layer of electrons. The outer shell, or

valence shell has a charge of -6, so it readily looks for other electrons to grab. Oxygen will

interact so that there are 8 electrons in their outer shell. This is seen in oxidation, or rusting,

which is either the gain of oxygen by a substance or the losing of hydrogen. This results in

oxygen taking electrons to satisfy their outer orbit. The “oxidized substance” loses (or to all

practical extents loses) their electrons.12

This will be discussed later in respect to cell membranes.

However, when oxygen reacts with hydrogen,

the chemical interaction results in a more

stable structure.

Figure 3 Hydrogen, Oxygen, Water

http://courses.bio.indiana.edu/L104-

Bonner/Sp10/imagesSp10/L8/WaterMPs.html

12 .ed Marieb, Human Anatomy and Physiology (2004) p 955

http://courses.bio.indiana.edu/L104-Bonner/Sp10/imagesSp10/L8/WaterMPs.html

http://courses.bio.indiana.edu/L104-Bonner/Sp10/imagesSp10/L8/WaterMPs.html


In a water molecule, there are two bonding pairs of electrons and two non-bonding pairs. These

four pairs of electrons repel one another, and in this way form a tetrahedral pattern. Because they

repel each other, they move as far away from each other as they can.

This sharing of the electrons is not a static occurrence. At times, the oxygen has the electrons. At

other times, the hydrogen has them. This transfer occurs multiple times per second. Hydrogen

bonds are not like actual chemical bonds, but are more like an attraction or a bridge. They are not

an ionic (ion transfer) or covalent (equal sharing) bond.

The hydrogen bond is almost 10 times weaker than a covalent bond. This feature is why they are

important as intra-molecular bonds. It is also why the slightly negative molecule is so readily

attracted with the slightly positive oxygen molecule.

This sharing of electrons results in a change of the structure of the molecule. When the oxygen

has the electrons, its field is larger and that of the hydrogen is smaller. When then hydrogen has

the electrons, they are relatively larger and also repelling each other somewhat, as they are more

negatively charged. Oxygen, being the larger molecule, has the electron more of the time due to

its mass. This means that the typical view of the water molecule is like the broken clock

reference, correct twice in a day. So in reality, the standard represented molecule is always in

motion, faster or slower dependent of temperature or stimulus, and bending and lengthening as

well.13

13 Girardin. Unpublished work


Figure 4 Model of Water Molecule

http://courses.bio.indiana.edu/L104-Bonner/Sp10/imagesSp10/L8/PlusCharges.jpg

Therefore, the standard tetrahedral angle of 104.5o is not precisely true at all times.

http://wps.prenhall.com/wps/media/objects/476/488316/ch01.html Introductory Chemistry

The properties of the chemical bonds of the water molecule are the reason that is makes such a

good solvent. It has a ready attraction to any molecule that can give an electron.

Figure 5 When Hydrogen has the electrons. When Oxygen has the electrons.

http://courses.bio.indiana.edu/L104-Bonner/Sp10/imagesSp10/L8/PlusCharges.jpg


4.2 Water as a Net

Water is known for its 3 phases – vapour, fluid, and ice. This is represented in the photo below.

Figure 6 Three phases of water

Gerald Pollack, of the University of Washington has extensively studied water and has found that

it organizes when it is near a border that is hydrophilic. This creates an exclusion zone, or area of

EZ water, that organizes with respect to charge. It is more negative “towards the border” of a

limiting hydrophilic container as water is typically negative due to abundant oxygen atoms, while

nearby, is the bulk water which has aligned with more positive hydronium ions, as they are free

to move about in the bulk water and are attracted to the more negative EZ water.14

14 Pollack, Gerald (2013) The Fourth Phase of Water – Beyond Solid Liquid Vapor p82


When water molecules are attracted to each other, they line

up according to the electric charges on the individual atoms.

This presents a 3-dimensional model of a regular structure,

more fixed in the solid state, and mobile in the fluid state.

Water will naturally follow the polarity of the charges. This

is of course exaggerated in the solid state. Ice becomes very

regular in its structure as seen in figure 10.

http://www.ifm.liu.se/compchem/research/hbonds Sweden

Figure 8 Beginning of a network of water.

http://hendrix2.uoregon.edu/~imamura/102/section2/chapter13.htm

l

Note that water is more dense as a fluid than a solid.

It is for this reason that ice floats and lakes don’t

freeze solid in the cold, but freeze from the top down.

This temperature inversion occurs at 4 °C.15

15 Angelo, Joseph Jr (2011) Liquid Matter p 49

Figure 7 Aligning water molecules

Figure 9 Crystalline lattice of water in solid state.

Figure 10Density of water molecules

http://hendrix2.uoregon.edu/~imamura/102/section2/chapter13.html

http://www.ifm.liu.se/compchem/research/hbonds





4.3 Water as a Polar Substance

As the water molecule has opposite charges on different parts of the same molecule, it is said to

be polar. Polar substances have charges that can interact with the charges in the water, and thus

are called hydrophilic. Non-polar substances lack charges and cannot interact with water, and are

called hydrophobic.

As water reacts with itself, through the attraction of the hydrogen bridges, it exhibits a property

called surface tension, which we see when water is beading on a hard surface. It may be easier to

think of it as "cohesion of water molecules" rather than as "surface tension."

As stated above, hydrogen bridges are weak. However, in large numbers, they have a strong effect,

overcoming even strong bonds. This is seen with the dissolving of sugar or salt in water: despite the

stability of the ionic bonds that hold these substances together, water disperses their molecules.

Saturation of the solute/solvent happens when there are no

longer enough hydrogen bonds to overcome the stronger ionic

bonds of the solute. Eventually the water can no longer

interfere with the ionic bonds holding the crystals together.

In chemistry, the rule for determining if a solvent will

dissolve a given solute is "like dissolves like." Solvents

composed of polar molecules, such as water, dissolve other

polar molecules, such as table salt. Nonpolar solvents, such as

gasoline, dissolve nonpolar substances such as wax.

In the body, non-polar molecules are fat soluble, thus having

significant importance in both digestion and metabolism.

http://www.personal.psu.edu/staff/m/b/mbt102/bisci4online/chemistry/chemistry3.htm Penn State

Figure 11 Water pulling the stronger ionic bonds.

http://www.personal.psu.edu/staff/m/b/mbt102/bisci4online/chemistry/chemistry3.htm

18 CHAPTER 5: WATER AS A SOLUTE AND SOLVENT

5 WATER AS A SOLUTE AND SOLVENT

In the previous chapter, the properties of water as a molecule and a solvent were discussed. It will

now it will be useful to put that information into place in the human body.

Biochemistry is termed “wet chemistry”: this is because biological molecules do not react

chemically unless they are in solution, and almost all chemical reactions that occur in the body

depend on waters’ solvent properties.

Water molecules are not static in a liquid form. They move and bend, and this is the basis for the

constantly changing milieu of the body, and for the rapid changes that can occur in homeostasis.

5.1 WATER AS A SOLUTE

5.1.1 Polar Solvent Properties

The polarity of water molecules explains why ionic compounds and other small reactive

molecules such as acids and bases dissociate in water, with their ions scattering, forming a true

solution.

Water also forms hydration layers (water molecule layers) around large charged particles, such as

proteins. This blocks them from the effects of other charged substances in the vicinity, preventing

them from settling out of solution. These protein/water mixes are biological colloids. Blood and

cerebral spinal fluids are good examples of this.16

16 Ed Marieb. Human Anatomy and Physiology (2004) p 40


5.1.2 Reactivity of Water

Water is also a reactant. It is essential to the process of hydrolysis, in which a food substance is

broken down by adding a water molecule to its building block. Conversely, some large protein or

carbohydrate molecules are broken down by removing a water molecule from its chain.

Disaccharides - two monosaccharides bound together by a covalent bond and

brought about by a condensation (dehydration synthesis) reaction which

produces one molecule of water. The reverse of this reaction separates the

two monosaccharides and requires water (hydrolysis).

Common examples include: maltose (glucose + glucose), lactose (galactose

+ glucose), and sucrose (fructose +glucose)

http://www.clt.astate.edu/mhuss/lecture_notes_-_unit_1.htm

The elimination of toxins in the body is done mainly by the liver through the feces, and also by

the kidneys and the sweat glands. Most toxins are fat soluble and must be converted to a water

soluble form in order to be excreted.

Toxins are removed in a 2 phase system. First, the toxins are converted to reactive metabolites

via processes such as oxidation reduction, hydrolysis and dehalogenation. While the toxin is in

the process of being converted, it remains active and toxic to the body. This can result in what is

sometimes termed a “healing crisis”. The body then works to change the chemical structure of the

toxin, to make it water soluble in order for it to be eliminated.17

17 WAhls, T. (2014) The Wahls Protocol. Pp 222-223

Figure 12 Hydrolysis and dehydration synthesis of

Disaccharides

http://www.clt.astate.edu/mhuss/lecture_notes_-_unit_1.htm


5.1.3 Water as a Protector

Water has a high heat capacity. It can absorb and dissipate significant amounts of heat,

moderating temperature. Therefore, the body is slow to react to heating due to external or internal

increases in temperature. As the blood circulates, it redistributes the heat among all the body

tissues, ensuring a general temperature homeostasis.

Water, being non-compressible in nature, can also act as a cushion to protect the body. Its ability

to flow, producing a resilient layer, protects structures, such the cerebrospinal fluid (CSF) with

respect to the brain. This is in conjunction with glycosaminoglycans (GAGs) and proteoglycans

and will be discussed further on in the paper.

5.2 General Fluids in the body

5.2.1 Intracellular Fluid

The body is made up of roughly 37 trillion cells, although this amount varies greatly depending

upon the author. This is not including the microbiome of the body, of which most estimates state

is in the magnitude of 10 greater than our number of cells. The water of the cells is not distinct

from each others “package”, but is in continuity through the extracellular fluid. However,

intracellular fluid often has different comcentrations of solutes compared to extracellular fluid.

For example, intracellular fluid is higher in potassium and magnesium, and lower in sodium and

chloride ions. The composition and behaviour of the intracellular fluid is similar, and therefore in

literature it is referred to as an entity, as opposed to trillions of entities. In addition, the

intracellular fluids respond quite similarly to tonicity changes in the extracellular fluid (ECF).18

18 Brandis K Fluid Physiology http://www.anaesthesiamcq.com/FluidBook/fl2_1.php

http://www.anaesthesiamcq.com/FluidBook/fl2_1.php


5.2.2 Extracellular Fluid (ECF)

The extracellular fluids include interstitial fluid (which is generally termed ECF), plasma, fluid of

bone and dense connective tissue, and transcellular fluid.

Interstitial Fluid (ISF) is usually referred to as one large pool of fluid in the body, but as it is so

widely distributed, it has many local variations, depending on the local metabolism and cellular

stresses. It bathes all the cells of the body, and is the link between the ICF and the vascular

system. This includes the lymphatics. Oxygen, nutrients, waste, and chemical messengers all

move through the ISF. It is lower in potassium and magnesium than the ICF and also higher in

sodium and chloride ions. In addition, is has a much lower protein concentration than plasma, due

to the action of the lymphatic system which removes it into the vascular circulation.

Plasma is actually a fluid pool, as it is continuous in its vascular system. It has a much higher

protein count than the ISF and it also differs in that it has a high flow rate. Blood contains red and

white cells in suspension, so that plasma has been called the interstitial fluid of the blood organ.

For this paper, this fluid will just be referred to as blood, as in Osteopathy, we do not make that

distinction in our treatment.

The fluid of bone and the dense connective tissue is of significance, containing approximately

15% of the total water in the body. This fluid is mobilized only slowly, but is of significance in

Osteopathic treatment.

The transcellular fluids are all those body fluids which are formed from the transport activities

of cells and are contained within epithelial lined spaces. These include the Cerebrospinal Fluid

(CSF) GastroIntestinal (GI) fluids, urine, aqueous humour and joint fluid.19

They are important

for their specialized functions. These fluids can vary greatly in terms of their ranges of chemical

contents due to their varied functions. In terms of this paper, we will discuss CSF in more detail.

19 Brandis K Fluid Physiology http://www.anaesthesiamcq.com/FluidBook/fl2_1.php



5.3 Extra- Cellular Matrix/Interstitial Fluid/Extra-Cellular Fluid (for

convention)

In 1975, Alfred Pischinger, the Professor of Histology and Embryology at the University of

Vienna presented his ideas on “The Ground Regulation System”. His system of ground regulation

is defined as:

“a function unit of the final vascular pathway, the connective tissue cells, and the final

vegetative-nervous structure. The entire field of activity and information of this trial is the

extracellular fluid. The lymphatics and lymphatic organs are connected with it. It is the largest

system penetrating the organism completely. It takes care of the nutrition of cells (internal

circulation) and the removal of waste products from them. Thus, it regulates the “cell milieu

system” and is at the same time part of every inflammation and defence process. It is thus

responsible for all basic vital functions.”20

The connective tissue, or the fascia, is comprised of cells, fibres and matrix. The cells are related

to structure, immunity, and energy reserve: fibroblasts, mastocytes, adipocytes, macrophages,

plasmocytes, lymphocytes and leucocytes. The fibres, or structural proteins, are collagen,

reticulin and elastin. There are specialized proteins such as fibronectin, laminin and fibrillin.

The matrix is the ground substance for the body tissues. It is comprised 70% of water both free

and bound, and 30% of colloids which are biphasic. The colloids include glycosaminoglycans,

proteoglycans, glycoproteins and other exogenous substances. 21

In Pischinger’s book Matrix and Matrix Regulation, he speaks of the Matrix as being made up of

glycosaminoglycans (GAGs), proteoglycans (PGs), collagen, elastin, fibronectin, laminin,

chondronectin among other substances, and “sea water”.

20 Pischinger, A (1991) Matrix and Matrix Regulation. Basis for a Holistic Theory in Medicine p 8 21 Voyer G. Fascia 0 polycopy


In the words of Pischinger: “Sea water is the primary regulation system of the single cell; the ion

composition of the structured extracellular space of multicellular organisms corresponds to this.

The milieu surrounding of a cell forms a structured basic substance in multicellular organisms

(extracellular matrix), which has a significant effect of determining the genetic expressivity of a

cell” 22

The GAGs are unbranched, negatively charged linear carbohydrate changes with repeated

disaccharide units of hexosamines and uronic acids, the most important of which are hyaluronic

acid, keratin, dermatan and chondroitin suphates, and heparin. The Hyaluronic acid is the largest

and most important GAG. Only hyaluronic acid and heparin are free, non-protein bound GAGs

and are therefore water-soluble. The high negative charge of hyaluronic acid makes it particularly

capable of binding with water, and ion exchange.23

Proteoglycans have a branching, brush-like

structure, in which a roughly 300 nanometre

(nm) long protein backbone contains

oligosaccharide chain bristles, forming as

such due to their electronegative charges.

The negative charge also makes it suitable

for binding water, and therefore a single PG

molecule can take up a very large amount of

space relative to its molecular weight.

Fibroblast (1) synthesizing extracellular matrix. The

proteoglycan network patter (2) is enlarged (arrow).

Proteoglycans (2a) are bound to hyaluronic acid 2b)

in the ground substance. From Pischinger Matrix and

Matrix Regulation p 23

22 Pischinger, A (1991) Matrix and Matrix Regulation. Basis for a Holistic Theory in Medicine p14 23 Ibid pp 45-46

Figure 13 Proteoglycan structure

http://www.swiss-alp-health.ch/science-articulation-enBref?lang=en

Figure 14 Fibroblast

http://www.swiss-alp-health.ch/science-articulation-enBref?lang=en


Enlargement of above fig. Link proteins (1) bind the

proteoglycan molecules to a hyaluronic acid (2). This is

stretched due to its negative charge. The same situation

exists with the polysaccharide chains (3), which are

stretched away from the protein backbone. The

interrupted lines give the “domain” of a proteoglycan

molecule. The double arrow shows the liquid-crystal-

bound water and the ion exchange capacity (arrow)

between the polysaccharide chains.

from Pischinger Matrix and Matrix Regulation p 25

The large structure of the GAGs and the

attraction to water, as well as the proteins which

have both hydrophobic and hydrophilic ends, create a type of cushioning in the ISF serving to

protect the cells of the body.

The interesting thing about ions, is that “like likes like”. Richard Feynman initially discussed this

and it was proven to be true much later. This makes the binding of molecules into

macromolecules more complex. The like is attracted to like if there is enough unlike between.

The interstitial fluid can be said to act as a fuelling station in terms of nutrients for the cells.

These nutrients come from the blood capillaries, and include glucose as well as minerals, salt and

fatty acids.

The sugar polymers of the extracellular matrix bind to the protein backbone, therefore the name

proteoglycans. The sugars have a very active role in most of the enzymatic reactions in the ISF

and the cells, as part of co-enzymes. The cleansing of the cells and movement of proteins out of

the ISF into the lymphatic system is beyond the scope of this

paper, except in terms of the physical movement, so the

biochemical interactions will not be discussed, but the reader

is urged to pick up a physiology book to better understand this

if they wish.

Proteins are long chains of amino acids, joined together by

dehydration synthesis, with the amine end of one amino acid

Figure 15 Enlargement of Figure 15

Figure 16 Alpha helix and Beta folding

structures.


linked to the acid termination of the next. This bond creates a typical arrangement of linked

atoms called a peptide bond. Polypeptides containing more than 50 amino acids are called

proteins, however most proteins are much larger, containing from 100 to over 10,000 amino

acids. Proteins do not exist as simple lines of amino acids. They self-organize to form more

complex structures. The most common of these is the alpha (α) helix. These self-organize in a

helical structure, with the hydrogen bonds in the alpha helices always linking different parts of

the same chain together. Another type of secondary structure is the Beta (β) pleated where the

primary polypeptide chains don’t coil, but link side by side via hydrogen bonds to create a folded

ribbon like structure. These structures can fold over on themselves repeatedly, forming tertiary

and quaternary structures.

The interest of these structures in this paper is the way in which water binds to the proteins.

While a protein with tertiary or quaternary structure appears rather like a lump, their structures

are very specific and are dictated by its primary structure. The types and relative positions of the

amino acids in the protein spine determine where the bonds can form to produce the complex or

folded structures that keep water-loving amino acids near the surface and water repelling amino

acids deep in the protein’s core.24

The spacing of amino acids along the collagen

backbone is optimal for binding water

molecules.25

The structure of water as a molecule is optimally

sized to attach along the coils of the protein

helix. The length from O to H is almost 1

angstrom (Å), but the water molecule distance

between the adjacent oxygen is 2.8 Å, therefore

having the space to attach to the protein. In fact,

proteins lack biological activity in the absence

of enough hydrating water, needing at least a

24 Ed Marieb E. (2004) Human Anatomy and Physiology pp 50-52 25 Berendsen HJC. (1962). Nuclear magnetic resonance study of collagen hydration

Figure 17 Demonstrating lattice in the coil for water

binding –Oschman ppt

http://en.wikipedia.org/wiki/%C3%85

http://en.wikipedia.org/wiki/%C3%85


monolayer covering (>1.5 mols H2O/mol amino acid residue). Spectroscopic studies show that

the structural water around proteins is affected at least 1 - 1.5 nm from its surface or 2 - 3 nm

between neighbouring proteins. Also, the glycans of the proteins act to structure the water out to

several nanometres, depending on the orientation. Water molecules bind to the surface of the

protein molecule due to the association of charge and polar groups and immobilization by

nonpolar groups. As an example, human serum albumin was found to have 2 layers of water

molecules surrounding the protein. Immediately adjacent to the albumin was a layer of water

molecules with the hydrogen atoms facing and the oxygen facing away; while in the next layer

the water molecules were 70% non-oriented. It is supposed that this promotes solubility of the

protein by maintaining its distances from the surface of other protein molecules.26

In solution, proteins have a structural flexibility, not seen in non-aqueous

environments. This allows water the freedom to hydrate the protein. Intra-molecular

peptide (amide) hydrogen bonding makes a major contribution to protein structure

and stability. The hydrogen bonds are responsible for the helix form, attaching

between molecules on each “spring coil”.

Schematic representation of a peptide chain in an α-helix configuration, showing

hydrogen bonding (dashed lines) that stabilizes the structure.

Hydrogen bond strengths are marginally stronger in α-helices rather than β-sheets. Internal water

in a protein enables the folding of the protein. It is eventually expelled from the hydrophobic

central core when squeezed out by the protein chain interactions.

The relationship between proteins and other solutes by hydrogen bonds is lessened if water is

competing for the bonding, for example, loosening the peptide bonds by lengthening them27

.

26

Biosep Sci pg 244

27 http://www1.lsbu.ac.uk/water/protein_hydration.html Oschmann

Figure 18 α-helix peptide chain

http://www1.lsbu.ac.uk/water/protein_hydration.html


The above mentioned “like likes like” has been demonstrated in some colloid studies by Norio

Ise of Tokyo University, This seems to contradict the usual DLVO theory of attraction between

particles taking into account Van Der Wal forces. The DLVO theory is applicable at very short

distances, while colloid have attractions at greater distances.28

This makes the binding of

molecules into macromolecules more complex, and reinforces the extreme changeability of the

solutes in the solvent. Particles do interact with the water, molecules in suspension are dynamic

and changing as evidenced by the gel/sol interplay discussed below.

Proteins developed in nature tend to be all left rotating, while sugars are right rotating molecules.

When they are made synthetically however, they are equally mixed as right and left rotating

substances. There is evidently some force in vivo that has an influence here.29

The complexity of water binding in ISF is very involved and will not be discussed here, as it

could fill many textbooks.

“A secret turning in us makes the universe turn.

Head unaware of feet, and feet head. Neither cares. They keep turning”

- Rumi

28 Pollack G. The Fourth Phase of Water. pp 125-133 29

Sheldrake, R. (2009) Morphic Resonance. Park Street Press. P 101


Figure 19 Non-mixing of Baltic Sea/North Sea and

Alaskan oceans

The movement of the colloids in the matrix through cellular activity and the binding and

unbinding of water with the GAGs helps to move nutrients to the cells and waste products

through the matrix to the lymphatics All of this fluctuating movement is palpable and contributes

to the therapeutic experience.

Movement is key; the system also requires movement to

stimulate change, water not moving does not mix and

different waters need stimulation to combine; dispersion

requires assistance. When you add sugar to a cup of

coffee you must stir it for it to go into solution. The

same for adding anything to water, for it to mix in, it

must be stimulated to move. This is evidenced in many

studies and also in nature, as you see the non-mixing of

oceans and rivers when they meet. The temperature,

salinity and chemical or sediment contact do not mix

automatically unless there is a physical stimulation to

mix. It is the same in the body, there must be a

stimulation to disperse the solutes in the solvent and

move the nutrients and waste products.

Pinterest


Figure 20 Running together of the Amazon and Rio Negro without mixing

Primary Respiratory Mechanism

The matrix is piezoelectric, marrying both electrical and mechanical functions. If an electric

stimulus is applied to the matrix, it causes mechanical motion (vibration) and a physical force

such as a compression, stretch or torsion creates electricity. As a water, the matrix is a semi-

conductor. Energy fluctuations spread rapidly through the matrix as changes in the liquid-

crystalline water. Because the matrix changes with external influences, it is prone to oscillation.

The macro-molecules are capable of this due to their spiral structure. Due to the constant

metabolic activity in the ECM, the macromolecules polymerize and depolymerize therefore

getting larger and then smaller, and this change of pore size of the matrix allows larger molecules

to move through the fluid. This gelatinizing of the matrix and then the reduction of it may be the

explanation for the Primary Respiratory Mechanism.3031

30 Voyer G. Course notes 31

Lee P. The Living Matrix: A Model for the Primary Respiratory Mechanism p374-378


Osteopathic Relevance

As Osteopaths, the differences in tissue qualities are noted even subconsciously. The relevance of

dehydrated tissue, in which proteins and metabolites are unable to move well, is indicative of a

tissue that will not regain health as readily as hydrated mobile tissue. Therefore, the goal of the

Osteopaths is to decrease the tissue congestion. Hands on work on the connective tissue to

engage the better exchange of nutrients is important. Thixotropy, the flowing of tissue with

mechanical deformation, is of course a key component of this.

This will be discussed further in Chapter 9, in relation to the work of Jean Claude Guimberteau,

the renowned French surgeon, who has been documenting the extracellular tissue for over 20

years.

In diabetes, or pre-diabetic conditions, the glucose in the interstitial fluid is increased and may be

sensed by an experience practitioner. In addition, hormonal differences such as with steroid use

are also noted by a practitioner who is accustomed to listening to tissue quality. There is a

pathognomonic oedematous feel to the tissue of someone taking anabolic steroids. This is also

seen in patients who take prednisone for various medical problems, and also in those who receive

corticosteroids for decreasing edema from chemotherapy treatment. Ironically it works for some

edema in the body, such as in the brain with tumours or for cardiac conditions, however creates

noticeable edema in the other tissues.

Chronically congested tissue is also an Osteopathic consideration. As mentioned above, the

congested tissue weakens the protein structure: if this is maintained, the tissue has less integrity.

Therefore, more care is a consideration with osteo-articular adjustments.


5.4 Cerebral Spinal Fluid (CSF)

"The first principle in the primary respiratory mechanism, the fluctuation of the cerebrospinal

fluid, has a potency with an Intelligence...”- W.G. Sutherland, DO

“…the cerebrospinal fluid is the highest known element that is contained in the human body, and

unless the brain furnishes this fluid in abundance a disabled condition of the body will remain.

He who is able to reason will see that this great river of life must be tapped and the withering

field irrigated at once, or the harvest of health be forever lost.” AT Still

“Finer nerves dwell with the lymphatics that even with the eye. The eye is an organized effect, the

lymphatics the cause, and in them the principle of life more abundantly swells. ….The fluids of

the brain are of a finer order than any fluids supplying the whole viscera”.32

The CSF is a clear, colourless fluid. It is secreted mainly in the lateral and third ventricles from

the choroid plexus epithelia via a leaky basal membrane with the tanyctes of the

circumventricular organs. It has also been found to form in the subarachnoid space in dogs by

steady state studies with ventricular perfusion.33

The CSF flows out from these ventricles through

the aqueduct of Sylvius to the fourth ventricle very quickly, as viewed on dynamic MRI.34

It then

flows out of the fourth ventricle through the midline foramen of Magendie and the lateral

foramina of Lushka into the subarachnoid space, which is made up of a number of interconnected

32 Still, AT. Philosphy and Mechanical Principles pg 66 33 Bering E, Sato O. JNeuroSurg Vol 20, no 12, pp. 1050 - 1063 34

Bechter K. The Peripheral CSFoutflow pathway. Neuro Psych &Brain Research Vol 17 No3 pp 51-66.


cisterns around the base of the brain. It flows around the tentorium upwards to the superior

sagittal sinus where a great part of it is absorbed in the arachnoid villi. Some is also absorbed in

the lateral ventricles. This is less in a normal ventricle but greater in a hydrocephalic ventricle

due to the ependyma flattening with increased ventricular volume.35

Some of the CSF flows

caudally in the spinal canal towards the lumbar subarachnoid space. This downward flow is

critical for fluid exchange and the pressure volume compensations as the total volume of lumbar

space may expand at the expense of the venous plexi in the spinal canal. There is evidence that a

disturbance of the flow in the spine may create fluid-filled syrinxes within the central canal of the

spine. The intra-ventricular pressure (IVP) is constantly changing to absorb the small but rapid

changes due to the movement of the fluid in the ventricles as the blood rushes into the choroid

plexus with each pulse, causing the IVP to rise. As the brain is inelastic and the cranial box is

rigid, this change in volume must be countered by either a movement of CSF or venous blood. As

the formation of CSF and absorption is not large, the venous system must make the allowances,

so that the rise in CSF pressure pushes the venous outflow to ease the pressure. This is seen on

cineventriculography.36

The flow from the large lateral ventricles siphoning down to the 3rd

and then the 4th

likely gives

rise to the above mentioned swift flow, or fluid jet, through the aqueduct of Sylvius seen on

dynamic MRI. Thus the CSF system is dynamic and responsive.3738

35 Bering E, Sato O. JNeuroSurg Vol 20, no 12, pp. 1050 - 1063 36 ibid 37 Bechter K. The Peripheral CSFoutflow pathway. Neuro Psych &Brain Research Vol 17 No3 pp 51-66.

.38

Kurtcuoglu V, et al Computational investigation of subject-specific CSF flow in the third ventricle and the

aqueduct of Sylvius. J of Biomec. 2007 Vol 40 p1235-1245.


http://schoolworkhelper.net/wp-content/uploads/2012/11/cebrospinal-

fluid-production.jpg

Quincke in 1872 demonstrated that CSF flowed out

from the subarachnoid spaces along the olfactory

nerves. The link between the cerebrospinal fluid,

the lymphatics and the extracellular fluid was

understood by the early Osteopaths, but neglected

by mainstream medicine for a long time. The

Osteopaths were detailed in their desire to make

their anatomical links.

The composition of CSF was of interest even in the

earlier days of Osteopathy. From the Journal of the

Osteopathic Cranial Association in 1948, listed the biochemistry of the CSF compared with other

body fluids, see below39

. It appears that the chemical content of this fluid was in another part

responsible for their feeling there was an anatomical link even though sophisticated fluid studies

were many years later.

Protein content -14-45 mg per 100 cc by lumbar puncture (100 x less than plasma)

-10-25 mg per 100cc by cisternal puncture

Sugar content -50% that of blood plasma, but this varies from 50-70% (50-75

mg/dL)

Non protein-nitrogenous contents vary from that of blood, depending on their diffusibility,

although all constituents are present in the CSF.

Total Non-protein nitrogen -12.5-30 mg per 100 cc

39 Swan, Keith (ed) (1988) Journal of the Osteopathic Cranial Association 1948. P41-43

Figure 21 CSF flow and Choroid Plexus

http://schoolworkhelper.net/wp-content/uploads/2012/11/cebrospinal-fluid-production.jpg

http://schoolworkhelper.net/wp-content/uploads/2012/11/cebrospinal-fluid-production.jpg


Urea -6-15 mg per 100cc (almost the same as blood)

Creatinine -0.45-1.5 mg per 100cc

Uric Acid -0.25-1.0 mg per 100cc

Amino acids 1-4 mg per 100 cc

Residual Nitrogen -2-6 mg per 100 cc (approx 50% of that of blood, due to its

diffusibility)

Chloride -720-750 mg per 100 cc (570-620 mg per 100 cc in blood plasma –

due to the Donnan equilibrium governing ion concentration across semi-permeable membranes)

Inorganic phosphate -1-2 mg per 100 cc (30%-50% of that of blood)

Cholesterol -practically none, due to the large size of molecule

Lactic acid -none

Hydrogen ion concentration -7.4-7.6 (same as blood)

Alkaline reserve -55-75 volumes percent as measured by the CO2 combining power,

the same as plasma

Sodium -300-380 mg per 100cc (same as blood)

Potassium -16-22 mg per 100 cc (same as blood)

Calcium -4.5-5.5 mg per 100 cc (all in ionized form) (same diffusible

fraction as serum)

Magnesium - 3.3 mg per 100 cc (slightly higher than in blood plasma) 40

The water content of the CSF is 98.5%.41

40 Swan, Keith (ed) (1988) Journal of the Osteopathic Cranial Association 1948 pp41-43 41 Marieb E (ed) ibid


This biochemical analysis from the 1940s was mostly confirmed with the book 'Acid-base

Physiology' by Kerry Brandis with the addition of the pCO2 level (50 mmHg). This results in a

lower CSF pH (7.33) compared to plasma.42

One major difference from the Osteopathic review is that the chloride levels are currently

regarded as 120 -130 mEq/L,or 90-106 mmol/L depending on the chart used, which is twice what

is reported in the 1948 Osteopathy journal. Two additions to the above information are IgG

concentration in the CSF is normally 4.6 ± 1.9 mg/dl and Albumin mean is 4.3 mg/dL.43


The movement of the CSF is important to the health of the brain and body and is studied in all

Osteopathic schools. It serves as a protector of the brain, as the brain floats in the CSF and can

act as a shock absorber.

Gradients of intracranial pressure are cancelled by the free mobility of the CSF, so there is less

risk of pressure gradient volume shifts or herniation. This is in part why the CSF is important in

the case of a head injury.

The medical diagnosis of “idiopathic hydrocephalus” is also relevant to Osteopathic treatment of

the free flow of the CSF in the ventricles.

The CSF will be further discussed later in the paper in relation with some other, newer relevant

information with the glymphatics and inflammation.

42 Brandis K. http://www.anaesthesiaMCQ.com 43

Ramkissoon, A https://answers.yahoo.com/question/index?qid=20100105052352AADQ4Xz

http://www.anaesthesiamcq.com/

https://answers.yahoo.com/question/index?qid=20100105052352AADQ4Xz


5.5 Lymphatic Fluid

Lymph is generally a clear, transparent or somewhat yellowish fluid that is alkaline and slightly

less viscous than blood. It is soluble in water, and can be considered as similar to blood, but

without the platelets and red blood cells. When lymph is filled with fat from the digestive system,

it is called chyle, and its white milky colour in this state is how this system was first discovered

by Herophilus (460-377 BC) , and then later again by Gasparo Asselli (1581-1626 AD Italy).

The water content of lymph is 96%, just less than CSF which is 98.5%, and greater than plasma

which is just over 90%.

Lymph contains sodium, potassium, chloride, calcium, phosphorus, magnesium, zinc, copper and

other substances in similar concentrations to plasma. This fluid has a variable protein load,

depending on the work it is doing. Proteins can escape from the blood circulation (75-100g, 50%

of the protein circulating in blood plasma can escape each day). These proteins are recovered

from the interstitium by the lymph system.

The lymphatics also recover toxins that have accumulated in the interstitium as a result of poor

exercise, poor diet, stress, toxin exposure, medications, poor oxygenation, and aging. This is

necessary to prevent large inflammatory reactions to these products, which can lead to significant

compromises in health. Lipids are carried from the digestive tract, and if the intestinal lymphatics

are impaired, the long chain triglycerides cannot be digested. In addition, the lymph carries

immune cells, such as lymphocytes 80-85%, macrophages (5-6%), and cells of the reticulo-

endothelial system such as Langerhans cells, dendritic cells, and so on.

The lymph also carries dead cells, migratory cells (cancer) mutant cells, cell and DNA fragments

from apoptosis, and foreign waste cells. When there is inflammation, there may also be mast

cells, platelets, eosinophils, granulocytes and even some red corpuscles. Other factors, nitric

oxide, AMPc, glucose and glycogen, urea, creatinine, hyaluronic acid (responsible for the

structure of the extracellular matrix gel), fibrin, prostaglandin 12, thrombomodulin, small


amounts of gases such as oxygen, carbonic acid, nitric acid and colourant, dust, food

preservatives and other toxins can also be carried in the lymph.44

The water base as a polar solvent allows the movement of this debris out of the extracellular

space and towards the necessary elimination.45

Figure 22 The Ground Regulation System from Pischinger


The chemistry of the lymphatic system is also complex, and not within the scope of this paper.

However, the movement of the fluid is of prime importance, and will be discussed in Chapter 8.

44

Chikly, Bruno. (2004) Silent Waves – Theory and Practice of Lymph Drainage Therapy. I.H.H. Publishing,

Scottsdale, AZ.

45 Chikly, Bruno (2004) Silent Waves – Theory and Practice of Lymph Drainage Therapy. Pp 35-36


5.6 Blood

As AT Still has told us, the circulation of the blood is of prime importance in the body. Everyone

understands the importance of blood to the human body. Without enough of it circulating, we die.

So, the continued flow is of concern to the Osteopath, to ensure an uninhibited circulation to all

parts of the body.

Blood plasma is basically tissue fluid, but with a greatly higher protein content, as the plasma

proteins are too large to diffuse through a healthy capillary wall. This fluid contains 55% plasma

and 45 % formed elements. The plasma is over 90% water, and contains electrolytes and mineral

ions (salts), carbon dioxide (mostly as a bicarbonate ion), plasma proteins (albumin being the

main, which helps to regulate the colloidal osmotic pressure), nutrients, hormones, and other

substances transported by blood. The formed elements suspended within the plasma are

erythrocytes (red blood cells RBC), leukocytes (WBC) and platelets.

The RBCs are the most abundant cells, facilitating oxygen transport by binding oxygen to the

haemoglobin, making if more soluble in the blood. Water molecules are integral to the structure

of the haemoglobin protein by stabilizing the internal structure. Oxygenated blood is bright red,

and darker when deoxygenated.46

The complexity of blood is beyond the scope of this paper. It’s relevance to health is evident, and

the circulation of it is of great importance to the Osteopath.


Anything to ameliorate the circulation, and the efficiency of nutrient supply and waste product

removal, is of great import to the Osteopath in the pursuit of health for the patient. This can

include assisting with stasis, removing impedance to free mobility of the more peripheral blood

vessels, or improving the mobility of the heart and major vessels.

46 Marieb E ibid


5.7 Synovial Fluid

The synovial fluid is mainly derived by filtration from blood flowing through the capillaries in

the synovial membrane. It is a viscous fluid, with the consistency of egg white due to the high

hyaluronic acid concentration which is formed by the synovial cells. This consistency is very

temperature dependent as it thins readily as it warms with joint activity. This fluid is also found

within the hyaline cartilage, giving a film that decreases the friction between weight

bearing/loading surfaces. When a joint is compressed, this fluid is forced from the articular

cartilage and when seeps back in when the pressure is reduced, thus bringing nutrients to the cells

of the cartilage as well as lubricating it.

If the loading is too extreme, part of hyaline articular cartilage is fluid.

Synovial fluid also contains phagocytes, which rid the joint cavity of microbes and cellular

debris. This is important as the articular cartilage does not have any vascular supply.47

Unlike fascia which exhibits thixotropic characteristics, synovial fluid is dilatantic. Dilatant

fluids are non-Newtonian. This fluid becomes thicker and more viscous when placed under

compression, and can change rapidly with physical exercise. This mechanism breaks down

without sufficient Glucosamine Sulphate

and Chondroitin Sulphate.

Synovial fluid has low amounts of

glucose, approximately equal to that of

blood, and a decreased amount may be

associated with articular diseases, such

as septic and immune-mediated

arthritis.48

Figure 23 Electrolyte composition of blood plasma,

ISF and ICF

Marieb p 1036

47 http://cal.vet.upenn.edu/projects/saortho/chapter_86/86mast.htm 48 Marieb E ibid p 1036

http://cal.vet.upenn.edu/projects/saortho/chapter_86/86mast.htm



The significance of this body “water” is two-fold. Osteopaths can affect the quality of the

synovial membrane with our hands on work, doing gentle articular work to improve the

circulation in the vascular supply and therefore improve the hyaluronic acid. In addition, we can

work to improve the quality of loading that the patient places on their joints, by modifying their

activities, encouraging weight loss, improving postural alignment to normalize joint

compressions and loading, and so on.

41 CHAPTER 6: WATER AND CELLULAR STRUCTURE

6. WATER AND CELLULAR STRUCTURE

In the complexity model, the definition of the system is its border with the environment. In

Biological systems, in the case of the cell, it is the cell membrane or plasmalemma.

6.1 Cell Membranes

We speak of cells as if they are individual entities in the body, but as explained earlier with the

network of water, the water is actually continuous both inside and outside the cells walls. The

cells are, to simplify, a product of an aqueous environment with its electrified grid pattern

between the molecules of H2O and the solutes within. The cell membrane is actually held in place

by the charge of the water molecules.

Molecules in living systems all contain carbon and are therefore called organic. Organic

molecules include proteins carbohydrates, lipids (fats) and nucleic acids. Lipids are like

carbohydrates in that they contain carbon, hydrogen and oxygen but have much less oxygen.

Phospholipids are a fatty molecule that evolved to contain a phosphate group, a simple organic

molecule such as choline and usually a

diglyceride. The two fatty acid chains in the

diglyceride are covalently bonded to the

phosphate, a strong bond. The phosphorus

containing head is polar and therefore attracts

water, while the two fatty “tails” are

hydrophobic and therefore hide away or rather

are pushed away, from the water molecules,

thus forming the typical bilayer wall.49

http://images.tutorvista.com/cms/images/101/phospholipids-bilayer.png

49 Marieb E ed. Ibid pp 47-48

Figure 24 Schematic of Polar Phospholipid

http://images.tutorvista.com/cms/images/101/phospholipids-bilayer.png


http://lamp.tu-graz.ac.at/~hadley/nanoscience/week4/4.html

In terms of evolution of the cell, when the first

molecules were self-organizing along with the

electrical charges and the emergent behaviour that

was demonstrated, and with being moved around

in the aqueous environment, they were jostled and

pushed together to form a fat drop, or micelle.

With further stimulation, such as a storm they can

be bounced around enough to form a liposome,

which is basically an empty cell. That is of course

without a nucleus and metabolic reactions, but that

evolution is not part of this paper.

Figure 25 The beginning of a cell before “evolution”

and life


6.2 Water Movement Through Cell Membranes

When this lipid bilayer was discovered in the 1920s, it was supposed that a certain amount of

water permeability would occur by simple diffusion through the plasmalemma. However,

physiologists felt that in certain tissues—for example, renal tubules, secretory glands, and red

cells—the water permeability is much greater than could be explained through simple diffusion

through the membrane. These researchers felt that there must be specialized water-selective

channels in these membranes.50

Aquapores were discovered in 1992 by Peter Agre purely by accident, -while studying

polypeptides. The discovered a polypeptide in red blood cells that they hadn’t expected to see,

and were surprised to find it was identical to one found in the kidney. This led his team on a path

of exploration and cloning to see the effects of these proteins. Agre won a Nobel Prize in

Chemistry in 1993 for this discovery. Aquaporines show a high selectivity for water, they also

reject H3O and hydrogen ions, although the drive by this osmosis is regulated by genes.51

Structure of AQP1–Hg++ inhibitory site. Space-filling representation of a single water molecule in the narrowest

point in the pore. Surrounding residues arginine-195 (Arg) and histidine-180 (His) provide positive charges that

repel.

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2658677/figure/fig2/

Functional schematic for water passage through AQP1. The extracellular vestibule and the intracellular vestibule

of the channel contain water in bulk solution. They are connected by a 20-Å span where water molecules pass in

single file.


50 Agre P.The Aquaporin Water Channels. Proc Am Thorac Soc. 2006 Mar; 3 (1) 5-13

51 ibid

Figure 26 Schematic of

an Aquapore 1

Figure 27 Functional

Schematic ofAQP1




The current view is that both mechanisms occur—diffusion through all membranes and flow

through aquaporins that are present in certain special membranes. The differences are quite

significant. Diffusion is a low-capacity bidirectional movement of water, while water channels

have a high capacity and great selectivity for water. The channels are so selective that water

passes through them, and acid does not.

Every day, our kidneys filter and reabsorb about 180 L of water. If we don’t reabsorb that water,

we would die of dehydration. If we reabsorb the water, along with metabolites, we would

systemically become acidotic. The water movement through the aquaporins is driven by osmotic

gradients. For example, if red blood cells were dropped into seawater they will shrink because

water leaves the cells. Red cells dropped into fresh water will swell and explode since water

enters the cell. This is the osmosis that we learned early in school as children. With aquaporins,

this happens much more rapidly.52

So, in the body, we are interested in this specialized

movement.

http://classconnection.s3.amazonaws.com/132/flashcards/1002132/jpg/image41360624348384.jpg

http://plantphys.info/plant_physiology/images/aquaporin.gif

52 Agre P. 2006 The Aquaporin Water Channels

Figure 28 Schematic of water movement across

cell membrane

Figure 29 Schematic with osmosis and

aquaporin

http://classconnection.s3.amazonaws.com/132/flashcards/1002132/jpg/image41360624348384.jpg

http://plantphys.info/plant_physiology/images/aquaporin.gif


6.2.1 Simple Fluid Absorption

Simple fluid absorption also occurs, for example in the GI system, which has 7-1.5 nm pores in

the tight junctions between epithelial cells. These permit waste to diffuse easily between the

lumen and interstitium. This is driven by the sodium (Na+) gradient from the lumen to the

interstitium. Na enters the epithelial cell by passive transport and is removed from there to the

interstitium by Na+-K+ ATPase, NA+ leaves the interstitium via the capillaries.

6.2.2 A Standing Gradient of Fluid Flow (via Aquaporins)

There are numerous types of aquaporins53

, depending on the structure.

Aquaporin proteins are made up of six transmembrane α-helices arranged in a right-handed

bundle. These aquapores allow water molecules to rapidly pass through single file, thus allowing

efficient regulation. In bulk solution in the ECF, there is a free movement of electrons between

the molecules. In the extracellular vestibule of the aquaporin “hourglass”, and the intracellular

vestibule, water exists in this bulk solution. However the centre of approximately 2 length of

the aquapore has a narrow diameter of only 2. , which is only wide enough for one water

molecule to pass through. In the aquapore are surrounding residues of arginine and histidine,

which provide positive charges that repel protons. The water molecules are therefore spaced

within the pores so that hydrogen bonding cannot occur between them. In the middle of the pore,

the isolated water molecule can transiently form hydrogen bonds to the side chains of two

asparagine residues, thus allowing water to move through the pore with no resistance. Other

protein channels allow for passage of other elements such as ions and larger molecules in a

similar fashion.54

53

Keener J, Sneyd J. (2009) Mathematical Physiology II 2nd ed Systems Physiologyp 853-859

54 Agre et al ibid


https://www.bioscience.org/2012/v4s/af/313/fulltext.php?bframe=figures.htm

The polarity assists with pushing the water through the pore rapidly in the narrow channel.

Figure 31 Schematic of simple aquapore with 2 α-helices showing

http://qph.is.quoracdn.net/main-qimg-76d0f4aa5788f5e071e1ef6afb636529?convert_to_webp=true

Figure 30 Schematic ofsimple water pore

https://www.bioscience.org/2012/v4s/af/313/fulltext.php?bframe=figures.htm

http://qph.is.quoracdn.net/main-qimg-76d0f4aa5788f5e071e1ef6afb636529?convert_to_webp=true


6.3 Embryological Considerations

Erich Blechschmidt, the German embryologist was one of the first people to realize that the

environmental stimulation of water plays a role in embryological development.

The environment of the water and the electrical grid within provokes two natural behaviours as

discussed above, osmosis and diffusion. This translates as a flow, or flux, and translation of

movement of molecules. When the stimulus for this movement or flow is lessened, of course the

movement slows.

Blechschmidt thought of this as a change in metabolic fields and used it to explain the form

changes and reorganization of cells in embryonic development. He stated the basic law of

ontogenesis is :

“Ontogenesis occurs by developmental biodynamic differentiations.”55

He describes that the growth function of any cell and group of cells must be thought of in relation

with the neighbouring cells activities and differentiation. Organs are not isolated structures but

have associations with the processes in their environment.

“There are no organs without functions, either during their developmental period or after they

have attained a definitive state.”56

Two Types of Tissue

Blechschmidt talks about 2 types of tissue; Frontier tissue and inner tissue. The frontier tissue is

the endoderm and ectoderm, and the inner tissue is the in-between tissue that binds everything,

55 Blechschmidt, E., Gasser R.F. (1978) Biokinetics and Biodynamics of Human Differentiation. p 3 56 ibid


the mesoderm. Frontier tissue is always between two completely different environments. The

behaviour is different as frontier tissue takes an impact of stimuli and reacts (absorbs and reacts

and metabolizes), and ejects it from its other end. It metabolizes the information from the inner

tissue and spits it out into the environment.

All life is movement, so all cells have metabolism. The inner tissue is all that is contained within

the frontier tissues and it is the place where the systems develop.

Blechschmidt states that the development into a morula is not from replication but from an

internal reorganization from the ovum. There is no change in size, but a re-organization into 30

cells. He states that is in not a symmetrical replication but an asymmetrical reorganization with a

maintained polarity. The organelles are de-centrated and the result is a repolarization into a

blastocyst.

As all cells are spitting out into the environment, the fluid

builds up into the intracellular space and a repolarization occurs

and the blastocyst forms. As the intercellular space gets larger it

organizes so most cells are on one side. There is a space for

fluid and there are cells all around. Metabolic activity creates

chemical concentration and diffusion into extracellular space of

the chemicals creates circulation.57

http://www.fssc.com.au/cleavage-versus-blastocyst-transfer-which-is-for-you/

The surrounding cells are held together by an attraction between their adjacent membranes. The

cellular activity causes some cells to change shape, reacting differently depending on their

adaptation to their position. Even by day 4 of development, the size of the blastocyst is still

relatively unchanged, but the cells within are pushed to the side by the fluid within. Blechschmidt

states that this form is due to the osmolarity of the liquid and is functionally important to

maintaining the shape of the blastocyst. This means that not only does it have a polarized shape;

it is functionally polarized as well. This is important as the blastocyst normally only attaches to

the uterine mucosa at its discal pole, which is necessary for further development.

57 Blechschmidt, E., Gasser R.F. (1978) Biokinetics and Biodynamics of Human Differentiation. p 11

Figure 32 Day 5 - Expanded Blastocyst

http://www.fssc.com.au/cleavage-versus-blastocyst-transfer-which-is-for-you/


With implantation, the ovum has a new positional relationship and therefore assumes a new

shape. Blechschmidt states “It is a consistent observation that position, shape and structure are

kinetically related throughout development.”

The growth of the ovum is due now to the supply of nutrients from the outside of the cell, as well

as from the blastocoel. The cells in the thinner walled part of the blastocyst release substances

into the blastocoel, as the wall lengthens and cells flatten. As the disc absorbs nutrients, it begins

to expand into the space of the blastocoel, and the thickening of the inner part of the disc forms

another cavity. Fluid from the adjacent cells then flows into the dorsal entoblast chamber and due

to this flow, they become polarized and therefore epithelial. Epithelial or frontier cells always

absorb nutrient from one side and expel metabolites from the other.

At the end of two weeks, two liquid connected cysts have formed with the entocyst disc of the

entoblast between.

The role of fluid movement in the development of the embryo is evident.

Fluid flow continues to be the stimulus for the development of the embryo and at the end of 8

weeks the embryo is formed.

Development continues to be a function of fluid movement.

The beginning of the circulatory system starts from the movement of fluid. The fluid movement

stimulates the epithelium (frontier tissue) of the cells that it passes by, and with continued

stimulation they no longer can absorb the force but begin to replicate, thus forming cells. These

cells replicate faster than other cells that are not in the trajectory of fluid, and therefore develop a

tube, which is a vessel. As it has formed from metabolites leaving other cells, it is the venous

system that is the first to form. This will then “steer” the circulation.58

58 Blechschmidt, E., Gasser R.F. (1978) Biokinetics and Biodynamics of Human Differentiation pg 9-19


Fluid flow promotes the coalescence of endothelial precursors, (angioblasts) into loose chords of

cells, the principle form of new vessel growth in early embryos.59

The arteries develop later and become thick walled due to the adaptation it must have due to the

force it is subjected to by the heart.

The heart is developed when it is compressed between the liver and the brain, and is actually not

a pump but a suction machine. It begins as a valve-less tube, which is then folded and twisted in a

process called cardiac looping. Peristalsis and impedance pumping have been proposed as the

possible mechanisms though which the embryonic, valve-less heart tube pumps blood. Recent in

vivo particle image velocimetry (PIV) suggests valve-less pumping. This relies on differences in

the resistance to the flow path between 2 possible flow directions coming from the active

pumping location, which is a result of deformation of the tube and propagation of passive elastic

waves and reflections. If there is a mismatch of impedency on either side, it produces a new flow.

Pressure differentials are created on both sides and this drives the flow in one direction.60

In 1932, Dr John Bremer, a Professor of Anatomy at Harvard University filmed the blood in the

very early embryo circulating in self-propelled mode in spiralling streams before the heart was

functioning. He was impressed with the spiralling nature of the blood flow pattern, but

apparently hadn’t realized that the presence of this negated the pressure propulsion principle.

Earlier in the 1920s, Rudolf Steiner of the Goetheanum in Switzerland had pointed out in lectures

to medical doctors that the heart was not a pump forcing inert blood to move with pressure but

that the blood was propelled with its own biological momentum, as can be seen in the embryo,

and boosts itself with "induced" momenta from the heart. He also stated that the pressure does

not cause the blood to circulate but is caused by interrupting the circulation. This will be

discussed later with the fluid movement in the body in Chapter 7.

59 Santhanakrishnan A, Miller LA. (2011) Fluid Dynamics of Heart Development. 1-22

60 Santhanakrishnan A, Miller LA. (2011) Fluid Dynamics of Heart Development. 1-22


The lymphatic system seems to derive from an overflow of the venous system. Lymph congests

in the interstices of inner tissues and when the veins can no longer handle the volume of fluid, the

interstices develop connections which form vessels. These vessels may stem from outgrowths of

large venous endothelial cells in the embryo (the cardinal veins). These small canals are

extensions of the endothelial walls of the vein. Valves appear in the lymphatic system around the

5th

month, which may indicate the presence of hydrostatic pressure in the embryonic system. The

valves in the vascular system appear one month later.61

The lymph nodes appear when the lymphatic system becomes congested. This occurs via the

development of lymph sacs initially, and they are then formed as the flow of lymph is obstructed

in the developing embryo.62

The vaso-vasorum is a micro-organ of the vessels. The development of this is likely linked with

the metabolic needs of the vessel walls as they develop. These are small, but have a large role to

play in the health of the vessels.

Thus the fluid is of prime importance in embryology and in our development, from the very

beginning. For further detail, please consult one of the Blechschmidt books in the bibliography.


When we have a patient with a complex problem, it is necessary to look at the whole picture, as

discussed earlier in terms of the complexity of the human body. For example, if someone comes

to us with a cardiac problem, we must ask ourselves some questions. First, where is the polarity,

why is this structure (the heart) not adapted to its function? Then, we must check local

intercellular movement, what is happening to the cells? Are there toxins, are they hydrated, is the

interstitium congested and if so why, and so on. After that, embryologically, we must check the

venous system, is it functioning correctly? After all that, we look at the aorta and heart, with all

their ligaments and related structures – can it move well, is the circulation compromised, is the

neural system compromised, etc. If we speak of the complexity of the human body, it is necessary

to respect it in our practice philosophy.

61 Chikly, Bruno (2004) Silent Waves – Theory and Practice of Lymph Drainage Therapy page 24-25 62 Blechschmidt, E. (2004) The Ontogenetic Basis of Human Anatomy, p189

52 CHAPTER 7: FLUID FLOW

7. FLUID FLOW

7.1 General

Newtonian fluid – a Newtonian fluid is one which exhibits a viscosity that stays constant

constant regardless of any external stress that is placed upon it, such as mixing or a sudden

application of force. It is possible for the viscosity of a Newtonian fluid to change if it is exposed

to different temperatures or pressures instead of external applications of force. Many fluids

become thicker as they are cooled, for example, though they still react to shear forces without a

change in viscosity.

The defining factor of any Newtonian fluid is that it will flow the same when a great deal of force

is applied as when it is left alone. This means that it can be mixed vigorously without changing

its viscosity. Regardless of the shear stress applied to these fluids, the coefficient of viscosity will

not change. Water is a Newtonian fluid, and as such, the blood plasma is generally considered

Newtonian in principle.

Non-Newtonian fluid – This can be contrasted with non-Newtonian fluids; these can become

thicker or thinner when stress is applied. This can be things such as clay, or synovial fluid, which

change viscosity with movement and pressure respectively. Thixotropic and dilatantic materials

are of course Non-Newtonian, and this is relevant to treatment as manual attention to these fluids

are of importance to Osteopathy.

Reynolds Number – named for Osborne Reynolds, a British engineer and physicist in 1883, he

demonstrated that the transition from laminar to turbulent flow in a pipe depends upon the value

of a mathematical quantity equal to the average velocity of flow times the diameter of the tube

times the mass density of the fluid divided by its absolute viscosity.

Laminar Flow – is defined as a steady flow of an incompressible viscous Newtonian fluid in

which the velocity of the fluid particles at any point is constant as time passes. However, the

architecture of the walls of the container cause a resistance, resulting in a slowing in fluid flow,

whether it is a river bed, pipe or vessel. The flow along this outer aspect is maintained by the

resistance of the wall, however the flow at this outer aspect maintains at the same velocity. The

http://encyclopedia2.thefreedictionary.com/Newtonian+fluid

http://encyclopedia2.thefreedictionary.com/Non-newtonian+fluid

http://www.britannica.com/EBchecked/topic/157956/density

http://www.britannica.com/EBchecked/topic/630428/viscosity


main criterion for laminar flow is a relatively small Reynolds number, which is related to fluid

density, velocity, viscosity and size. At higher Reynolds numbers, the flow becomes Turbulent.

Turbulent Flow – is an extreme kind of unsteady flow which occurs where there are sharp

obstacles or bends in the path of a fast moving fluid. The velocity at any particular point changes

erratically from moment to moment, both in magnitude and direction.

Boundary Layer Flow – is the flow beside the boundary of the fluid, which is slowed or stopped

by the resistance offered by the boundary. It can be laminar or turbulent. In the body this is

generally the vessel walls.

Viscosity - The viscosity of a fluid is a measure of its resistance to gradual deformation by shear

stress or tensile stress. For liquids, it corresponds to the idea of "thickness". As an example,

honey has a much higher viscosity than water.63

7.2 Vascular Circulation in the Human Body (in vivo)

The circulation in the body has been studies for many years, and I don’t want to repeat any

physiology texts. Doppler studies have shown great details of circulation. We understand from

physics that fluid flow in a system in related to the flow and the diameter of the tube. However, it

is evident that this is not the case in the body, as the vessel sizes are smaller when one moves

farther away from the heart. In addition, in a living system there is a large amount of interaction

with the vessel walls with respect to responses to the speed and pressure of the flow. The arteries

appear to have the ability to dampen the velocity relative to the diameter of the walls. Stimulation

of vessel walls can have a myriad of physiological responses. Autonomic regulation,

mesenchymal stem cell stimulation and secretion of products (see below), production of Nitrous

Oxide (NO) (see below), and productions of hyaluronic acid in joint capsules (see Section 5.7 )

all occur through the stimulation of the epithelial walls.

63 eds Halliday D, Resnick R, Walker J. (2001) Fundamentals of Physics 6th ed. Pg 332-335

http://encyclopedia2.thefreedictionary.com/Viscosity

http://en.wikipedia.org/wiki/Drag_(physics)

http://en.wikipedia.org/wiki/Shear_stress

http://en.wikipedia.org/wiki/Shear_stress

http://en.wikipedia.org/wiki/Tensile_stress

http://en.wikipedia.org/wiki/Water


Physiology textbooks have chapters on the blood, the heart and the circulatory system with the

major and minor vessels. I want to introduce instead a few different views, in line with the

complexity models discussed in Section 3.4.

An article from the Center for Frontier Sciences at Temple University in the USA was written by

Ralph Marinelli, refuting the idea that the heart is a pump. Among his argument is that the arch of

the aorta is a curved tube, which instead of straightening under pressure appears to curve further,

signifying a negative pressure change. When the pressure and flow are measured in the aorta, the

pressure peaks before the fluid velocity. This also seems to bear out the argument for the heart as

a negative pressure unit.64

This works well with the embryology work of Blechschmidt, but not

so well with the standard view of textbooks everywhere. This is augmented by the negative

pressure from the respiratory pump pulling blood in through the venae cava.

Of course, the major determinant of cardiac output is venous return. Again, with any heart issue,

the venous system must be considered. This of course has interesting significance for Osteopathy

as we can directly work on the venous return through manual drainage techniques and circulatory

exercises.65

Vaso-constriction

Peripheral blood flow may decrease with low blood pressure, but it may also decrease with very

high blood pressure caused by intense vaso-constriction. Intense vaso-constriction may also play

a role in Tako cardiomyopathy, as one theory of the cardiac arrest from the adrenergic storm from

the pheochromocytoma is that the vaso-vasorum constricted so forcefully on the coronary arteries

that the heart goes into arrest. This will be discussed in a practical sense with a case study of a

patient, whose vaso-nervorum may have also reacted, closing the movement of fluid in the spinal

and peripheral nerves.

Endothelial Walls

64

Marinelli, Ralph, et al. The Heart is not a Pump: A Refutation of the Pressure Propulsion Premise of Heart

Function.1995 Frontier Perspectives

65 Goldberg S. (1995) Clinical Physiology made ridiculously simple. Medmaster. P 17


The primary role of the endothelium is to form a semipermeable membrane which retains the

plasma and formed elements of the blood within the circulatory system while allowing nutrients

to readily move through the walls to allow nutrients into the tissues. The glycocalyx and

intercellular junctions are permeable to small solutes such as glucose, and a system of endothelial

vesicles mediate the transfer of plasma immunoglobulins, and protein bound minerals and

hormones.66

It’s commonly understood in the medical field that disturbances to vascular walls, such as with

lesions from smoke due to the free radicals (it is known that the carbon monoxide and nicotine

are less damaging than whole smoke). These endothelial lesions promote the development of

atherosclerosis.

Reversing (small reversed pulsation) –

The endothelium in the abdominal aorta, iliac and femoral arteries experiences an oscillating

stress with both forward and backward directions with each cardiac cycle. This does not occur

with exercise, as the flow demand is greater. This is thought to be related to why the abdominal

aorta is more prone to atheroma that the thoracic aorta which does not experience this small

reversal of the shear stress on the epithelial walls. Oscillatory shear stresses in vessel walls are

capable of stimulating leucocyte adhesion to cultured endothelial cells.67

Atheromas form in area

where there is both a high amplitude and low mean of pulsatile shear stress and a reversal of

shear stress.

Nitric oxide (NO) is produced in the endothelial cells from L-arginine and oxygen, and this

transaction can be activated by mechanical strain of the cell membrane by shear stress. Nitric

oxide has a known ability to prevent cell adhesion, modify lipid transport and vasodilate and thus

66

Levick, JR. (2003) An introduction to Cardiovascular Physiology 4th ed.

67Snow, HM. Atheroma and the mechanics of blood flow in Arteries Irish Journal of Medical Science Vol 171 No 3.


may be a possible reason for the mediation between the shear stress and atheroma. Dr Snow, an

Irish physiologist has done experimentation, and concluded that the main stimulus for the release

of NO was the mean component of shear stress, however the cause to create atheroma seemed to

be more related to mean shear stress rather than the pulsatile shear stress.6869

Mochizuk et al have concluded that the hyaluronic acid glycosaminoglycans within the

glycocalyx play a pivotal role in detecting and amplifying the shear force of flowing blood that

triggers endothelium-derived NO production in isolated canine femoral arteries.70

Shear Stress and Atherosclerosis

Low

Sedentary activity results in low shear stresses in the lower extremities which may result in

increased oxidative stress and impaired endothelial function and subsequently atherosclerosis. If

a sedentary lifestyle is combined with inadequate diet, the NO may be less available to help

prevent atheroma despite not being exposed to extreme shear stresses. In fact, the relationship

between blood flow shear stress and NO production provides a good explanation for the benefits

of exercise.7172

High

The shear stresses required to cause damage to the endothelium are much higher than in normal

circulation, for this reason, extreme athletes can be prone to endothelial damage.73

68 Snow, HM. Atheroma and the mechanics of blood flow in Arteries Irish Journal of Medical Science Vol 171 No 3. 69 Li YJ, Haga J, Chien S. Molecular basis of the effects of shear stress on vascular endothelial cells. JBiomech 38

(2005) 1949-1971 70 Mochizuk S, Vink H, Hiramatsu O, Kajita T, Shigeto F, Spaan JA, Kajiya F. Role of hyaluronic acid glycosaminoglycans in shear-induced endothelium-derived nitric oxide release. Am J Physiol Heart Circ Physiol. 2003 Aug; 285(2) 71 Snow, HM. Atheroma and the mechanics of blood flow in Arteries Irish Journal of Medical Science Vol 171 No 3. 72 Thosar, S. Sitting and endothelial dysfunction: The role of shear stress. 2012 Dec 1. doi: 10.12659/MSM.883589

PMCID: PMC3560806 73

Cioni,G. et al Impaired Femoral Vascular Compliance and Endothelial Dysfunction in 30 Healthy Male Soccer

Players March 23, 2015 http://sph.sagepub.com/content/early/2015/03/21/1941738115577931

http://www.ncbi.nlm.nih.gov/pubmed/?term=Shigeto%20F%5BAuthor%5D&cauthor=true&cauthor_uid=12730059

http://www.ncbi.nlm.nih.gov/pubmed/?term=Spaan%20JA%5BAuthor%5D&cauthor=true&cauthor_uid=12730059

http://www.ncbi.nlm.nih.gov/pubmed/?term=Kajiya%20F%5BAuthor%5D&cauthor=true&cauthor_uid=12730059

http://www.ncbi.nlm.nih.gov/pubmed/12730059

http://www.ncbi.nlm.nih.gov/pubmed/?term=Thosar%20SS%5Bauth%5D

http://dx.doi.org/10.12659%2FMSM.883589

http://sph.sagepub.com/content/early/2015/03/21/1941738115577931


Search of Sports Medicine articles shows an incidence of arterial damage in cyclist which is

frequently repaired surgically, after conservative measures of anti-inflammatories and rest fail,

resulting with mixed results.7475

This is likely related to the creation of turbulence with the

relative occlusion and the mechano-transduction of the inguinal vessels which has an impact on

the endothelial walls.7677

Aneurysm

There is much research on computerized aneurysm modelling, which seems to bring out similar

flow patterns as seen in vivo. Aneurysms result from regions of the vasculature that have

weakened walls. This may be congenital, or as a result of atherosclerosis or chronic hypertension.

When there is a weakening, the fluid flow becomes turbulent, creating regular eddies that are

seem on computer models as well. They frequently occur at the abdominal aorta and arteries to

the brain and kidneys. This may show that a pressure gradient is involved.78

79

Tezduyar

These are not a part of what is treated in Osteopathy, but caution must be taken with treatment in

any risk areas. It would be clinically advisable to have a stethoscope to auscultate in any cases

where there may be a question of aneurysm. The sound is of an erratic turbulence, rather like a

scratching or screeching.

Adjacent Walls

There is an impact on flow by the nearby structures. For example, the contraction of the

myocardium compresses the smaller vessels. When there is a decreased movement in the area of

a large vessel, such as the abdominal or thoracic aorta it may lead to the question “is the body

protecting the circulation”. If there is a rigid, flat back, or a thoracic lordosis, the first thing to

74 Quinn, Elizabeth (2013) Treating Iliac Artery Endofibrosis and Vascular Problems in Cyclists

http://sportsmedicine.about.com/od/bicyclinginjuries/a/Arteriopathy_2.htm 75

TakachT, et al. Arteriopathy in the High-Performance Athlete. Tex Heart Inst J. 2006; 33(4): 482–486. 76 Tarbell, J., Weinbaum, S., Kamm, R. Cellular Fluid Mechanics and Mechanotransduction. Annals of Biomedical

Engineering Vol. 33 No12. pp 1719-1723 77 Fry, D.L., Hemodynamic Forces in Atherogenesis. In: Cerebrovascular Diseases. Ravens Press, 1976, pp77-95. 78 Marieb E ed Human Anatomy and Physiology 79 Tezduyar et al. (2007) Modelling of fluid-structure interaction with the space-time finite elements: Arterial fluid

mechanics. In J for Num Meth Fluids 54: 901-922

http://sportsmedicine.about.com/od/bicyclinginjuries/a/Arteriopathy_2.htm


check is the vascular system. As Still would say, the “Rule of the Artery is Absolute” and it often

will block movement to protect its limited flexibility. If the abdominal aorta is too restricted, it

will begin to erode the spine.80

7.3 Cancer

The interstitial fluid (ISF) pressure in cancer is well established to be increased above the normal.

The tumor ISF pressure is uniform throughout the centre, and drops rapidly in the periphery. The

mechanisms may be due to contraction of the interstitial space by stromal fibroblast, interstitial

fibrosis, blood vessel leakiness or lymph vessel abnormalities. This leads to a decrease in

movement of lower molecular weight compounds such as glucose, therapeutic antibodies or

drugs in the tissue. High ISF pressure is linked with poor prognosis. Tumors require blood

vessels for growth, however the vessels are irregular, saccular, convoluted, leaky and have

defects in pericyte coverage and function. These abnormalities make the blood flow in tumor

inefficient, and the growth of the tumor itself can block the circulation. Lymphatic vessels are

absent or non-functional in tumours, which also leads to increased ISF pressure, but they develop

around the tumor. The tumor cells and secretion have therefore an increased migration from these

forces to the lymphatic. In fact, it can often be seen that increased flow though lymph nodes is

seen before the arrival of metastases.81

Again this is something for the Osteopath to be aware of

while treating.

7.4 Pressure Gradient

The flow of arterial blood and the high pressure is modulated by neural input in the distal vessels,

as they narrow, thus they are not overwhelmed with the flow. Pressure in the capillaries ranges

from 20-44 mm Hg, as high BP would rupture the thin walls. This low pressure is enough to

force the filtrate out into the interstitial spaces and distribute the nutrients, gases and hormone to

the tissues.

7.5 Mesenchymal Stem Cells

80 Girardin, M Class notes. 81

Heldin et al. High Interstitial Fluid Pressure – An Obstacle in Cancer Therapy. Nature.com Oct 2004 Vol 4.


The newborn is rich in stem cells, which decrease greatly as we age.

There are two categories of stem cells: Mesenchymal stem cells found in most tissues of the

body, and CD 34+ found in bone marrow and umbilical cord blood. Mesenchymal stem cells

surround our blood vessels, and when stimulated, secrete many chemicals to help with the

maintenance of healthy tissue. They help with vascular repair and maintenance (also sustaining

their “home”, they modulate the immune system, especially with

increasing the activity of Regulatory T-cells , and stimulate

regeneration of Growth Differentiating Factor-11, which can

reverse age related cardiac hypertrophy. As well, CD34+ which is

a subset of adult peripheral blood leukocytes acts as endothelial

cell progenitors called angioblasts which can affect neo-

vascularization, having an impact on hematopoesis, WBCs, RBC,

platelets, and innate immunity via endothelial progenitor cells.

From Neil Riordan PPP Orthomolecular Conference 2015

As well they promote secretion of many substances

when the walls of the small blood vessels are stimulated by flow.

IGFBP--‐4 protein consistently inhibits several cancer cells in vivo and in vitro

Follistatin—antagonist to myostatin

HGF--‐major role in adult organ regeneration and in wound healing, markedly accelerates

remyelination in multiple sclerosis

A more complete list of secretions from mesenchymal stem cells is found in the appendix.


Figure 33 Mesenchymal Stem Cell on blood vessel


The significance of this in Osteopathy is great. We can work to increase the circulation by freeing

restrictions of flow. We can also work on the venous return via a circulatory massage, to improve

the venous flow throughout the system. In addition, encouraging appropriate exercises to the

patient plays a very large role in stimulating these stem cells.

The stem cell research is an exciting new field and it will be interesting to learn more as the

research on exercise and stem cell stimulation increases.82

82 Riordan N. PPP at the Orthomolecular Conference Toronto April 2015.

61 CHAPTER 8: DRAINAGE OF FLUIDS – LYMPHATICS AND GLYMPHATICS

8. DRAINAGE OF FLUIDS - LYMPHATICS & GLYMPHATICS

Cleansing of the body also takes place in terms of water and solutes. There are two main liquid

clean-up methods of the interstitial fluids.

8.1 Lymphatics

As noted above, fluid is continually being exchanged between the vascular system and the

interstitium and is returned to the vascular space via the lymphatics. The overall net balancing of

this movement determines the amount of fluid in the tissue. If there is too little fluid in the

interstitium, the tissue is dehydrated, while excess fluid remaining in the tissue causes oedema.

A quick review of the vascular role shows there is a net outflow of fluid from the vascular

system, which is governed by 4 forces known collectively as the Starling forces.

Fluid in the capillary is under hydrostatic pressure pushing fluid across the wall and out of

the capillary (Pc).

This is countered by the hydrostatic pressure in the interstitial fluid outside the capillary

(Pi) trying to force fluid into the capillary.

The capillary wall acts as a semipermeable membrane restricting the movement of

proteins into the interstitium which causes an oncotic/osmotic pressure (πc) drawing water

into the capillary

This is balanced in part by the oncotic pressure of the interstitial fluid (πi) which of course

also contains protein.

This produces a net flow overall of movement of fluid out of the capillary, as the πi is less than

the πc. There is of course a greater outflow in fenestrated capillaries than in continuous

capillaries. Many textbooks of physiology argue there is a net of fluid being drawn back in at the


venular end of the capillaries, with the rest being taken care of by the lymphatic system.

However, it is now being thought that there is little vascular reabsorption.83

Measurements of the interstitial fluid pressure are difficult to perform accurately with the

interstitial space containing a gel like mesh of water and

molecular chains. It has been seen on measurement that the

interstitial fluid pressure can be zero or sub-atmospheric,

which leads to a pulling of water out of the capillaries. This

would indicate that the interstitial pressure has little to do

with the fluid reabsorbing into the capillaries, meaning the

large job of draining the fluid falls into the lymphatic

system; therefore to prevent oedema the lymphatic system

works to drain the interstitium.84

From Kirkman and Sawdon – see bibliography

www.thymate.com

Generally physiology textbooks will state that the

Starling forces produce 4 litres per day of lymphatic

fluid, which is based on studies of lymphatic movement

through the thoracic duct. However, this does not take

into account the amount of lymphatic fluid reabsorbed

into the bloodstream from the filtration that occurs in

lymph nodes. Up to 50% of the water from the lymph in

the lymph nodes is reabsorbed into the capillaries, again

via the Starling forces.

83

Wittlinger, G, Wittlinger, H. (2 4) Textbook of Dr. Vodder’s Manual Lymph Drainage, Vol 1, 7th ed. Thieme,

Stuttgart, Ger. 84

Kirkman, E, Sawdon, M. (2004) Capillary dynamics and interstitial fluid lymphatic system An Int Care Med, (5)2.

Figure 34 Pressure gradient in lymph

collection

Figure 35 Schematic of lymph node with afferent

and efferent vessels.

http://www.thymate.com/


This of course reduces greatly the lymphatic return in the thoracic duct, therefore the 4 litres per

day is a conservative measure of the total lymph taken in by the lymphatic capillaries.

The interstitial filtrate enters the lymphatic vessels, which are similar to blood capillaries with

and endothelial layer, but they have large intercellular pores and therefore are very permeable to

both water and larger molecules such as proteins. The capillaries merge with afferent lymphatic

trunks and the fluid movement is aided by both muscular contractions of the smooth muscle in

the walls and of the surrounding muscles when travelling through skeletal muscle, as with veins.

(see fig above) The fluid is

moved through lymph nodes

and out again to the large

lymph duct, the thoracic duct

and enters the venous system

at the level of the conjunction

of the subclavian and jugular

veins, to be filtered by the

kidneys and ultimately

excreted.

http://philschatz.com/anatomy-book/contents/m46563.html


In this day of environmental toxins, poor quality of air and poor quality of food that many people

ingest, more people seem to be in a state of inflammation. The resulting tissue congestion shows

to an Osteopath the absolute power of fluid to create movement disorders and pain. A good

understanding of how to work this system and also assist in the cleansing of the interstitium is

very important to the Osteopath. Poor cleansing of tissue and poor stasis of tissue are definitely

warning signs to an Osteopath.

Figure 36 Lymph capillaries in the capillary bed

http://philschatz.com/anatomy-book/contents/m46563.html


Clinically, it has been noted for years by the writer of this paper that frequently, immediately

preceding an osteopathic release of a tissue, as small gurgle would be heard, somewhere in the

patient’s body. This was initially just an interesting observation, but this grew in mind over the

years. It was then noted that while working on some patients, especially in vascular areas, they

would suddenly say that they had developed an intense pain somewhere else in the body during

the treatment. They would say it was very intense, and that it was an artefact of the current

treatment technique. Why working on an inguinal area would cause their head to feel like it

would explode was puzzling, but after hearing it from different patients, it was impossible to

ignore. This, coupled with intense groin or pelvic floor pain while working on a shoulder

restriction in the axillary area started some light bulbs to go off. Going to treat the lymphatics in

the area of complaint produced immediate reduction of pain, but would sometime resurface

elsewhere. It became apparent that the lymphatic system is very pressure sensitive, and almost

like a semi-closed hydraulic system. When one area began an improved drainage, they system

would be overwhelmed and wouldn’t drain elsewhere, resulting in increased fluid pressure and

pain. Either the Osteopathic treatment of the region in pain, or subsequently having the patient

compress gently subclavicularly would immediately produce a calming and disappearance of the

pain.

Working on lymphatic congestion has demonstrated the power of the fluid to limit movement of

soft tissue and even joints, thus the proper mobility of the lymph needs to be a consideration of

every Osteopath.

8.2 Glymphatics

For many years it was puzzling that the high metabolic activity of neurons in the brain would

indicate that there was a need for a rapid removal of their waste products. However, it was long

thought that the brain had no lymphatics. There is exciting new research into the cleansing of the


brain by a group of scientists in New York. They have discovered a new system of cleansing in

the brain, akin to lymphatics that is in large part governed by movement past the glial cells which

has inspired the name Glymphatics.

The blood-cerebrospinal fluid barrier is constituted of choroid plexus epithelial cells and

tanycytes, with inter-epithelial tight junctions. The CP epithelial cells are defined as a subtype of

macroglial cells. It was long thought that the CSF was the removal system for waste products

diffusing from the brain. However, the large tissue distances in much of the brain would be

difficult for diffusion and bulk flow to cleanse the interstitium.

The research team headed by Maiken Nedergaard has done imaging of live mice as their brains

are small enough to view the direct observation in an intact brain. Using two-photon microscopy

imaging, they have discovered a brain-wide pathway consisting of three elements: a para-arterial

CSF influx route, a para-venous ISF clearance route and an intracellular trans-astrocytic path that

joins the two extracellular

paravascular clearance

pathways.85

The CSF flow is not only

dependent on production in the

choroid plexus but also on water

flux in the Virchow-Robin, or

pericapillary space. This space is

bound by the surface of the

blood vessel and the apical

processes of astrocytes. Water

channels on the vascular end-

feet of the astrocytes called Aquaporin 4 (AQP4)

assist the flow out of the para-arterial space and into the interstitium, see figure 38.

85

Thane A, Thane VR, Nedergaard, M. Drowning stars: Reassessing the role of astrocytes in brain edema. Trends

Neurosci. 2014 Nov; 37 (11).

Figure 37 The CSFandits traffic to the lymphatic system

Ref -Drowning Stars - Astrocytes


As the CSF permeates with the ISF, vectoral convective fluxes drive waste products away from

the arteries towards the veins. The ISF and its constituent waste products then clear the brain

along large-caliber draining veins, reaching the lymphatic vessels in the neck and eventually

returning the contents into the systemic circulation. The CSF can also exit via the arachnoid villi

extending through the membrane and allow CSF to exit into the vascular system. The blood with

the solutes and proteins are eventually degraded by the liver and eventually secreted.86

This has been discovered by use of various sizes

of fluorescent tracers into the lateral ventricles of

anesthetized mice. The mice were used as they are

small enough to view the entire volume of the

brain and the interstitium. Texas Red-dextran-3

(TR-d3 - size 3 kiloDaltons), Fluorescein

isthiocyanate-dextran-2000 (FITC-d2000 size

2000kD) and Alexa Fluor 594 hydrazide (FITC-d

- 759 daltons) were the tracers used. The larger

molecular weight tracers distribution differed

greatly from the small molecular weight tracer. In

30 minutes, the FITC entered the brain along the

para-vascular pathways, but was confined there,

and the TR-d3 concentrated in the para-vascular

space but also entered the interstitium from not

only the para-vascular space but from the pial

surface as well, and therefore had a greater distribution than the very large. The lower molecular

A594 quickly moved through the interstitium of the brain and only small amounts concentrated in

the para-vascular spaces. Within the 30 minutes, the A594 had permeated almost the whole brain

volume. This was also confirmed by injection of the other tracers into the cistern, with smaller

molecular weight tracers moving more quickly into the brain.

86

Nedergaard, M. Garbage Truck of the Brain. Vol. 340 no. 6140 pp. 1529-1530 DOI: 10.1126/science.1240514

Figure 38 Schematic from Paravascular Pathway

article


Previous studies had been done with larger molecular weight substances which suggests that

these studies were not able to study the true movement of the fluids.87

After this, the team used two-photon

laser scanning microscopes to

visualize in real time the pathway and

movement of the CSF into the brain

parenchyma. It showed rapid tracer

movement along the paravascular

pathways and entry into the brain

along the outer surface of arteries and

arterioles. This was confirmed by ex

vivo studies of cross-sections after

injections, revealing tracer exiting

primarily along two para-venous

routes, the lateral-ventral caudal rhinal

veins and the medial internal cerebral

veins. This has been confirmed by

injections into various loci, with the

migration of the tracer to the major vein pathways.88

A study by Thomas Mathiisen from Norway has done his PhD on the glio-vascular unit. He has,

with his team, published work demonstrating the perivascular astrocytic endfeet might serve as a

sieve, accounting for the size dependency of paravascular solute entry into the interstitium89

.

87

Yang L et al. Evaluating glymphatic pathways function utilizing clinically relevant intrathecal infusion of CSF

tracer. J Transl Med 2013 May 1:11:107. 88

Iliff J et al. A Paravascular Pathway Facilitates CSF Flow Through the Brain Parenchyma and the Clearance of

Interstitial Solutes, Including Amyloid β. Science Translational Medicine Org. Aug15, 2012. Vol 4 No 147. 89 Mathiison T, Lehre K, Danbolt N, Ottersen O. The perivascular astroglial sheath provides a complete covering of

the brain microvessels: An electron microscopic 3D reconstruction.Glia. Mar 2010 DOI: 10.1002/glia.20990

Figure 39 Pathway of tracer influx in brain.


Other studies have demonstrated that the bulk flow of the tracers is linked with the arterial

pulsation.90

The researchers also noted that when the dura mater was pierced, the paravascular tracer flux was

almost abolished, which suggests that maintaining the hydraulic integrity of the subarachnoid and

paravascular spaces is of critical importance for maintaining the paravascular bulk flow.

Studies have also been done on mice genetically engineered to lack AQP4, which have shown

significantly decreased clearance of soluble proteins. This lead to studies injecting mice with

brain extracts with aggregation-prone forms of human tau protein, inducing self-assembly of the

wild-type human tau into filaments, resulting in the pathological spread of tau aggregates to distal

regions of the brain.

Traumatic brain injury with axon damage increases the tau concentration in the brain by a large

factor, as much as 40,000. Thus, as the tau-laden CSF enters the brain tissue, it is taken up by the

cells close to the para-vascular boundary, creating a large typical para-vascular tau-

immunoreactive neurofibrillary tangle, thus decreasing fluid flow in the region. Beta-amyloid (β-

amyloid) may also be delivered by this system, contributing to the growth of para-arterial

deposits in cerebral amyloid angiopathy. This provides more potential for research into

neurodegenerative diseases such as ALS and Alzheimers.

Structural changes to the glmphatic system such as from perivascular reactive gliosis or AQP4

trauma can persist for some time after an injury or infart, thus both traumatic brain injury and

stroke can severely impair the function of the glymphatic system and the clearance of metabolites

from the brain. 91

Of interest to note, Iliff and Nedergaard et al have also studied the effect of sleep on the fluid

movement in the brain. With mice that are sleeping, fluid movement is significantly greater, thus

indicating that the volume of the interstitial space was much greater in sleeping mice than awake.

Aβ protein were eliminated at the same rate whether the mice were asleep or anaesthetized,

90 \Iliff et al. ibid pp13-15. 91 Thane A, Thane VR, Nedergaard, M. Drowning stars: Reassessing the role of astrocytes in brain edema. Trends Neurosci. 2014 Nov; 37 (11).


suggesting that it is the sleep-wake cycle, not a circadian rhythm that determines the intercellular

space and therefore the speed of clearance of the interstitial fluid.92

Due to the activity of the fluid and the response, it is thought that the Positron Emission

tomography (PET) scan is of greater use to view the brain.93

Of great significance for the Osteopaths is the sequelae of traumatic brain injuries in clients. A

recent article by McKee, a researcher at the United States Department of Veterans Affairs,

suggests that chronic traumatic encephalopathy (CTE) may represent a unique tauopathy with

characteristic pathological stages. However, it is not clear from the published methodology to

determine a causal relationship between concussion or subconcussive impacts being a risk factor

for CTE.

A review article on Medscape from the British Journal of Sports Medicine it was stated that in a

screening survey of 513 retired NFL players (average age=61 years) 35% produced scores

suggesting a possibly mild cognitive impairment. In another recent study of former NFL players,

the death rate from neurodegenerative diseases was three times greater than that of the general

population, although the number of cases in this study was small. More specifically, the rates of

diagnosis of Alzheimer’s Disease (AD) and amyotrophic lateral sclerosis (ALS) were found to be

four times higher in former NFL players than the general population. Of the 334 former athletes

in this cohort, seven (2.1%) had ALS listed on their death certificates. This issue of ALS is in

keeping with the TDP43 tauopathy seen in CTE cases. However, this review was unable to make

a specific link between the brain damage seen on autopsy as related to symptoms. This continues

to be a large topic in sports, as the reported incidence of concussion grows with more

awareness.94

92 Xie L, et al. Sleep Drives Metabolite Clearance from the Adult Brain. Science 2013 Oct 18: 342 (6156) 93 Iliff J, et al. Brain-wide pathway for waste clearance captured by contrast-enhanced MRI. J Clin Invest; Mar 2013; 123.3 1299-1309. 94

McCrory P et al. What Is the Evidence for Chronic Concussion-related Changes in Retired Athletes Br J Sports

Med. 2013;47 (5):327-330.



The glymphatic pathways demonstrated in mammalian brains give a very logical explanation for

physiological mysteries such as the previously puzzling lack of lymphatic system in the brain

despite the extremely high metabolic activity. This was a result of testing with molecules too

great to pass through the barrier, and gives the Osteopath a very useful insight into the

effectiveness of treatment of the ventricles and the venous sinuses, with a whole new layer of

tissues to address and another view of the fluid flow in the interstitium.

71 CHAPTER 9: TISSUE QUALITIES

9. TISSUE QUALITIES

9.1 Images Under the Skin

Jean-Claude Guimberteau, a French plastic surgeon has specialized in reconstructive surgical

repair of wrist and hand tendons. Seeking to better improve his techniques he decided to observe

the sliding of the tendons in vivo, with use of a microvideo camera. This was long before the

days of digital cameras.

He was surprised to find the sliding mechanism of tendons as taught in all his textbooks was not

apparent. Instead, he observed that the extracellular matrix connected all the structures in the

wrist. They appeared to do so in a way that allowed a gradient of movement to occur without

disturbing the continuity of the matrix.

The areolar connective tissue and paratenon actually allows movements between the connecting

structures preserving mobility and independence of the tissues with all the surrounding structures

and the skin. This mechanically offers a great importance, greatly diminishing friction while

allowing easy deformability. He termed this system a multimicrovacuolar collagenous absorbing

system (MVCAS).

These vacuoles range in size from a few microns to a few millimetres or more. The MVCAS has

an abundance of water. On observation, one can see droplets of water running along the

filaments. Each time a flap of skin is lifted a different arrangement of fibres and water is seen,

The collagen is dynamic, able to change form, divide and slide. Collagen and elastin fibres are

able to adapt readily under mechanical stress to resist strain. The lymphatic and vascular systems

connect to this framework as well, moving and adapting to changes of position without rupturing.

This allows a continuous uninterrupted blood and neural connection. These vacuoles are within a

pseudo-polygonal fibrillar framework containing a gel. The framework is to ensure that the

structures can move freely when stimulated. It also has a memory, to return to its initial position

between movements.95

95

Siemionow M. ed. (2006) Tissue Surgery. Springer-Verlag, London. Eng. Pp 41-47


Images from under the skin.

These microvacuoles contain water and

glycosaminoglycan polymers. They break open during

observation with the camera.

The collagen network looks “wet” because of the

hydrated glycosaminoglycan gel.

These “dew” droplets form because of the destruction

of the structure during observation.

The underlying network - smaller fibers within

larger ones, throughout the body.

All photos from website of Dr Guimberteau.

Figure 40 Microvacuoles in the MVCAs

Figure 41 “Wet”collagen network.

Figure 42 Water droplets formed from destruction.

Figure 43 The underlying network of connectivity.



In Osteopathy, we treat the body as an interconnecting unit. This work actually confirmed the

connectivity of the ECM and the organized dense connective tissue. This ability to actually

visualize what happens under the skin as movement occurs brings a whole new dimension to our

treatment of the fascia. We must treat it not a tissue that slides on itself, but in a more three-

dimensional sense.

9.2 Hydration

Dr F Batmanghelidj, a British trained physician, has written numerous books on the importance

of water and hydration with catchy titles such as “You’re Not Sick, You’re Thirsty”, and “Your

Bodies Many Cries for Water”. His own life experiences in a Tehranian prison taught him how to

treat peptic ulcers with water and opened his eyes to viewing water as a necessary nutrient. He

outlines clearly the processes of water requirements in the body and disease processes due to the

lack of hydration. He explains its importance in immunity, cleaning and clearing toxins,

increasing the efficiency of red blood cells, reducing risk of heart attacks and strokes,, preventing

atherosclerosis, curing peptic ulcers, heartburn, colitis, headaches and migraines, asthma and

allergies, hypertension, diabetes, constipation auto-immune disorders, high cholesterol, coronary

artery disease, kidney stones, gout, intermittent claudication, and many many more diseases

commonly treated with medications that he treats with drinking water. His work is highly

recommended to read for further reference.

Water as a solvent is involved in regulating all the functions of the body, including the metabolic

activities of all of the solutes dissolved (or in suspension) in it. Water transports hormones,

chemical messengers and nutrients. Every cell requires approximately 75% if its volume at

minimum to be water in order to perform it’s normal functions for the body.

The water that we drink is unbound water, and is free to be absorbed quickly into the intestines

and into the interstitium. Water ingested in the form of food, or other liquids is not free, but

bound with other substances, therefore must be processed as such and broken down subsequently

as a nutrient thus is not free to move wherever needed in the body.


Hydrolysis, as discussed earlier in this paper in the ECF section, is involved with the breaking

down of complex proteins into amino acids and of breaking down large fat molecules into fatty

acid units. Hydrolysis, by its very name means the breaking apart of water, and this is what

occurs in these chemical actions. Therefore water is also a nutrient, and necessary for the

breakdown of our food into useful nutrient products for the body.

The neurotransmitter histamine is very involved in the regulation of water. It primarily regulates

the thirst mechanism, to increase water intake. It also is responsible for the body trying to

maintain the rationing for water for priority systems in a dehydrated body.

The concept of a dry mouth meaning you are thirsty is a gross understatement. Saliva is produced

to assist with chewing and swallowing food, even in a dehydrated state. Therefore, to not have

saliva means that dehydration is advanced.

When the body is dehydrated, it works to maintain functions as well as it can. For example, when

there is a significant lack of water in the body, from water loss or lack of water intake, the body

reflects this loss in various places, 66% in the volume of cells, 26% in the fluid environment and

only 8% in the volume in the vascular circulation. The loss of blood is adapted for by closing

down some peripheral capillaries, and later the larger vessels close somewhat to take up the rest

of the volume loss, leading to a tension in the arteries. This is the beginning of hypertension. In

addition, for the water in the blood to get to the interstitium, it must be under pressure to cross the

vessel wall. Histamine regulates this as well, by activating production of vasopressin an

antidiuretic hormone.96

Histamine is also linked with the renin-angiotensin system to conserve water, but this is more

complex and involves salt retention and edema by way of conserving enough water for urine, also

giving rise to higher blood pressure. This is not part of the purpose of this paper, so the reader is

recommended to a physiology textbook for further reading.

Histamine production increases exponentially when the body becomes more dehydrated. When

the tissue is hydrated, the histamine production and release is inhibited proportionally to the

96

Batmanghelidj, F. (2003) You’re Not Sick, You’re Thirsty. Hachette Book Group, NY, NY.


increase. With prolonged dehydration, there is a greater than normal production and storage of

histamine, so when there is a stimulus for the release of histamine for example from the immune

system, the body produces more histamine than normally would have been released. In terms of

antigens, a dehydrated body’s immune system is already compromised with decreased production

and efficiency of antibodies. In terms of pollen “allergies”, the body then reacts by watering of

eyes, for example, to try and clean the conjunctiva as there are not enough antibodies available to

attack the invader. This leads to unwanted symptoms; therefore leading people to taking

medication to block the reactions from histamines. But this limits the effectiveness of histamine

function. The action of histamines in the body should not be continuously blocked by use of

medication. The immune system components are brought by the water system, and histamine

promotes the bringing of water as needed. In a hydrated system however, the actions of the

histamine are not exaggerated, as mentioned above.

When we drink water by itself away from food, it immediately passes through the stomach to the

intestines and is absorbed. Within half an hour, almost the same amount of water is secreted to

the stomach through the glandular layer in the mucosa to assist with the digestion of food, and the

maintenance of the protective mucosal layer. Acids and enzymes break down the food, assisted

by the stomach contractions but large amounts of water are needed for it to be digested. No food

leaves the stomach until it is all broken down into chyme, a homogeneous fluid of body

temperature. 97

9.3 Cation pumps

Neurotransmission systems of the brain and nerves rely on the ability of sodium and potassium to

rapidly move in and out of the membrane of the nerve along its length. Water must be free and

not bound with another substance can move across the cell membrane and mobilize the element

moving pumps. Some of these pumps are able to generate voltage. As mentioned in Chapter 6

water enters via osmosis through the cell membrane, and this flow of water can push the pump

units that force potassium into the cell and push sodium outside the cells, just as with a

hydroelectric generator, creating a voltage gradient that is stored in the form of ATP and GTP

97 Batmanghelidj, F. (1997) Your Body’s Many Cries for Water. Global Health Solutions.


and used for elemental (cation) exchanges. ATP and GTP are of course major energy sources in

our body. This water is also responsible for energy reserves.

Energy in cells - These energies are stored in 3 different storage pools, ATP, GTP and also in the

endoplasmic reticulum, capturing and trapping calcium. For each 2 units of calcium trapped, the

energy equivalent of one unit of ATP is stored in their ionic connection. This calcium storage in

our bones is therefore also an energy reserve. In the case of severe dehydration, this may be

linked with loss of calcium from bones and subsequent osteoporosis.98


Congested tissues, dehydrated tissues, lack of energy in tissues are all things that are seen in an

Osteopathic practice on a regular basis. Placing our hands on someone will often tell us how

quickly we can have success with them, based on the tissue quality. It is clear that it is not only

the decreased mobility of the fascia that is involved with the sensation in our hands, but it is true -

the differences are due to the hydration factor in many cases. Patients must be encouraged to

drink adequate amounts of water for their health and the efficacy of the Osteopathic treatment.

98 Batmanghelidj, F. (2003) You’re Not Sick, You’re Thirsty. Hachette Book Group, NY, NY. P 184

77 CHAPTER 10: WATER AND ENERGY

10. WATER AND ENERGY

10.1 Thixotropy

Thixotropy is one of the oldest documented rheological phenomena in colloid science. It was

named by Herbert Freundlich of the Freundlich Institute in Berlin in the 1920s from a suggestion

by T. Peterfi who had earlier found that cell protoplasm could be liquefied by mechanical action.

It was originally used to describe a mechanically induced sol-gel transition, without any mention

of a time factor. This continues to be a large area of study, in industry and healthcare, for

pharmaceuticals as well as Osteopathy. The changes in microstructure underlying thixotropy are

complex and not well understood, despite being a common occurrence in natural systems. Some

study applications are in the aim of increasing the time scale to achieve as rapid a recovery of

viscosity as possible after a sudden decrease in shear rate or shear stress, such as with mud.

However in the body, we are interested in increasing the shear flow of the cell protoplasm and the

interstitium.99

Kerst et al have studied the thixotropic properties of filamentous actin and found that when

subjected to a stimulus of oscillatory shearing at frequencies from .00d – 30 radials (---), the

suspension immediately exhibited gel state behaviour and dropped rapidly upon stopping the

stimulus. The state recovery was almost complete after 5 minutes of “rest” before re shearing.

Their conclusions were that the filamentous actin demonstrated a “polycrystalline texture” with a

diffusion limiting recovery. They feel that the filamentous actin suspension behaved like a

domain, similar to miniature moving ice flows in solution, as opposed to individual molecules.

99 Mewis J, Wagner N. Thixotropy. Advances in Colloid and Interface Science. 2009. p 214-227,


They propose some theories involving different models of explanation of thixotropy, with

relation to cytoplasmic streaming, as other studies has confirmed links between contraction

(shearing) of cytoplasm and its get-sol transition. Their data suggests that any contractile

mechanism generation sufficient shearing forces would independently cause a get-sol

transition.100

Cytoplasm and suspensions of actin exhibit complex fluid behaviours that likely play a role in

cytoplasmic streaming, movement of vesicles through the cytoplasm and bulk flow. The

cytoplasm and actin solutions are shear thinning, which show a constant shear stress for flow

rates. They interpret their findings to explain that high flow rates do not necessarily require large

forces and a small difference in the concentrations of filaments can account for flowing or

nonflowing cytoplasm.

10.2 Electromagnetics

During the 1950's, an innovative Swedish radiologist and surgeon, Dr. Björn E.W. Nordenström

(second photo) became interested in streaks, spikes and coronas that he saw in X-ray images of

lung tumours. After years of very careful experimentation and analysis, he came to the

conclusion that the streaks, spikes and coronas that could be seen in X-ray radiographs of lung

tumours were due to the movement of water, movement of ions and restructuring of certain

tissues due to the influence of various electrical and electrochemical phenomena. From his

research, he concluded that all matter is condensed energy. He describes Biologically Closed

Electric Circuits (BCEC) the mechanisms of which contain the capacity to initiate structuring and

functioning of matter. In this partial theory of the biological evolution these BCEC may be a key

mechanism, providing the important primary steps necessary for the transfer of non-biological

into biological matter. Other factors are evidently contributing to biological differentiation,

including for instance the principle of differential selection of species. Due to their basic role, the

100

Kerst A, et al Liquid crystal domains and thixotropy of filamaentous actin suspensions. Proc

Natl Acad Sci Vol 87 pp 4241-4245


BCEC systems can nevertheless be recognized to be involved in the majority of structural and

functional expressions in biology. 101

Schumann Resonance

At any given moment about 2,000 thunderstorms roll over Earth, producing some 50 flashes of

lightning every second. Each lightning burst creates electromagnetic waves that begin to circle

around Earth captured between Earth's surface and the boundary layer of the ionosphere about 60

miles up. Some of the waves - if they have just the right wavelength - combine, increasing in

strength, to create a repeating atmospheric heartbeat known as Schumann resonance. These

waves oscillate with regions of greater and lesser energy. The “sweet spot” for the resonance of

these waves is for the wavelength to be very long, 2-3 times the circumference of the earth. This

creates and extremely low frequency wave that can be as low as 7.8 Hz. As it flows around the

earth, it hits itself again in such a way that the troughs and crests of the wave reinforce

themselves.

Schumann resonances were named after German physicist Winfried Schumann, who first

predicted them in 1952. These have been reliably measured since the 1960, and scientists have

discovered that variations in the resonances correspond to changes in seasons, solar activities

(solar flares), activities in the earth’s magnetic environment, water aerosols in the atmosphere and

other Earth-bound phenomena.102

This frequency is similar to the frequency of the brain.103

This phenomenom has been studied in

relation to the role of the Schumann Resonance signal detected by human brains and used to

synchronize diurnal and ELF brain rhythms. It has been found to affect multiple health issues

depending on the SR signal outside of the normal homeostatic range, influencing such health

issues as cancer and cardiac and neurological mortality.

101

Nordenström, BE. The paradigm of biologically closed electric circuits (BCEC) and the

formation of an International Association (IABC) for BCEC systems. Physiological chemistry and

physics and medical NMRVol 21 No 4 p 249-255.

102 http://www.nasa.gov/mission_pages/sunearth/news/gallery/schumann-resonance.html

103 heart math institute https://www.heartmath.org/research/global-coherence/

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22Nordenstr%C3%B6m%2C+B+E%22

http://www.nasa.gov/mission_pages/sunearth/news/gallery/schumann-resonance.html

https://www.heartmath.org/research/global-coherence/


Schumann Resonances, are a plausible biophysical mechanism for human health effects. The

Solar Flares Research in Russia in the Siberian Institute of Physics and Technology has

confirmed this. They have found that variations in the SR can affect human encephalograms in

the frequency range of 6-16 Hz. This confirms the effect of electromagnetics from an external

source affecting the body physiology.104

Electromagnetics have been studied in terms of health care by many researchers and it is clear

that this can affect the human organism. Trained hands have also been demonstrated to affect

tissue via electromagnetics. This is not directly in relation with the topic in this paper, so will

only be touched on briefly to say that in the body, the fluid transmits well the electromagnetics,

as a function of its structure.

The migration of cells in the body has been proven to be electrically driven, following membrane

potentials. These potentials arise from the segregation of charges the by special molecular

machines (pumps, ion channels, transporters) in the plasma membranes of cells. Ion gradients has

been shown to direct many cellular and molecular-based processes such as embryogenesis and

wound healing.

10.3 Energy Medicine

10.3.1 Laying on of hands

In the early 1960s Dr Bernard Grad, a gerontologist At McGill University in Montreal became

interested in the concept of “laying on of hands” (LH) healing. He was trying to determine if the

results that had been reported of healing in this way was due to psychological or placebo effect,

or an effect of true energetic effects on the physiology from legitimate healers. He decided to

base his experiments on animals and plants to nullify the effect of suggestion in the process of

treatment. After finding statistically significant improvement with treating goiter and wound

104 Pobachenko SV, Kolesnik AG, Borodin AS, Kalyuzhin VV. The contingency of parameters

of human encephalograms and Schumann resonance electromagnetic fields revealed in

monitoring studies (2006) Biophysics Vol 51 No 3 pp 480-483.

http://link.springer.com.proxy.queensu.ca/search?facet-creator=%22S.+V.+Pobachenko%22

http://link.springer.com.proxy.queensu.ca/search?facet-creator=%22A.+G.+Kolesnik%22

http://link.springer.com.proxy.queensu.ca/search?facet-creator=%22A.+S.+Borodin%22

http://link.springer.com.proxy.queensu.ca/search?facet-creator=%22V.+V.+Kalyuzhin%22

http://link.springer.com.proxy.queensu.ca/article/10.1134/S0006350906030225



http://link.springer.com.proxy.queensu.ca/journal/11439


healing in mice through the laying of hands, he decided to try and test the indirect method of

water to plants. He created the “sick plant” by use of saline water as salt is a growth inhibitor.

Two flasks of saline water were prepared at 1% solution. He then had a known local healer treat

one flask of water. The soil of these two groups of plants were then soaked with these saline

solutions, then allowed to dry. They were subsequently watered with only tap water for a period

of time. After 12-15 days, they were analyzed for size and health. The treated water plant was

significantly taller and leafier with higher levels of chlorophyll. These experiments have been

reproduced a number of times in his lab and also in other labs.105

Using infrared absorption spectrometry, Grad analyzed the treated water and found the bond

angle of the molecule has slightly changed. This allowed the healer treated water to have a

slightly different molecular structure, and the molecules then bound in a slightly different way.

The surface tension of the water was decreased. He later experimented with a psychotic

depressive, a healer with a green thumb who loved plants, as well as a cleaner who was so

surprised and excited to be asked to participate in an experiment, that she had statistically

significant results with the water, although not quite as good as the cleaner. The plants with the

regular water were the control while the depressed patient’s plants did statistically poorer. This

lead Grad to think of intention being of importance as well, for the cleaner has been found to be

cradling the bottle like a baby prior to the experiment, instead of just holding it as required.106

Dr

Robert Miller, a research chemist in Atlanta Georgia repeated Grad’s experiments successfully,

but also found a significant similarity in the energetic effect of magnetic fields and the field

effects of psychic healers. He discovered that water treated by psychic healers had a reduced

tension in the same manner as water treated by magnetic fields. The stability of these changes

was found to last approximately 24 hours. Miller did further experiments with plants and the

105

Otto H, Knight J ed. Dimensions in Wholistic Healing. New Frontiers in the Treatment of the Whole Person.

(1979) Nelson-Hall Inc.

106

Gerber, R. (1996) Vibrational Medicine. Bear and Co.


comparison of watering barley plants with tap water, magnetized water and water treated by a

healer LH water). The LH water and magnetized water plants were significantly healthier.

Dr Justa Smith, a biochemist in New York discovered Grad work shortly after completing her

doctoral thesis on magnetic fields and enzymes. She decided to test the effects of healer’s hands

on increasing enzyme reaction rates, so set up experiments comparing LH with magnetic fields.

She used one of Grad’s psychic healers for her experiments, having him hold a vial with a

solution of the digestive enzyme trypsin and had him imaging doing a LH healing. She then

tested each sample on a spectrophotometer to register the level of the enzyme activity. She noted

that over time, the healer was able to increase the enzyme reaction rate more greatly and the

length of time the healer held the test tube, the faster was the enzyme reaction rate. Other

enzymes were tested, and some appeared to have a slowing rate. When these results were later

analyzed, it was discovered that all the enzyme reaction activities were towards a greater health.

All these experiments lead to a direction of thinking that a trained healer and a good intent have a

large effect on the water of the body, as water and as a part of a solution.

Unfortunately, none of these studies in this last section are printed in peer-evaluated journals, but

they are well known studies, so they were included in this paper.


It is to be hoped that each Osteopath is a trained healer, with good intentions to their patients. A

better knowledge of anatomy and physiology and of where to focus their intent and at what level

of tissue or system would indicate that the impact to the water in that focus area would improve

its function. That is good news, and should be stressed to all Osteopathic students: Listen to the

body and communicate with it with the best of intentions!

10.4 Fluids in homeopathics

Dr Jacques Benveniste, a French immunologist, was a successful researcher who had discovered

Platelet Aggregating Factor in 1970 at Scripps Clinic in California. In France, he patented an

allergy test involving staining degranulated basophils, the Human Basophil Degranulation Test


(HBDT). In 1988 Benveniste reported that he had discovered a surprising behaviour in

leucocytes.

Leucocytes contain in their cytoplasm granules of histamine and other immune mediators which,

when provoked, produce an allergic reaction. This plays a role in anaphylactic reactions IgE is an

antibody on the outside of basophils which recognizes and binds to allergens. Benveniste used

Anti-IgE in his experiments to trigger an immune response. As they continued to dilute the anti-

IgE in their testing, the responses were surprisingly increasing in intensity. They reported effects

of the anti-IgE well into the ultra-molecular range – up to 10-120

. This was puzzling to him, and

he theorized that the water still held the electromagnetic signature of a substance long after the

substance is molecularly absent. This is the basis of Homeopathy.

After further research with comparable results, he published his work in Nature in June 1988 but

was vilified for the radical work. Other labs repeated his work, with mixed results, due to

protocols, but he was condemned for bad research. He had criticisms of the other laboratories

protocols, and responded with more research, this time showing the changes occurred with

similar large dilutions of anti-IgE and not with anti-IgG which does not provoke degranulation.107

Benveniste later did work with cellular signalling and the interruption of the coagulation of

plasma by the presence of calcium. . Heparin is commonly used as an anticoagulant, but instead

of adding heparin, he exposed the calcium water to the digitized electromagnetic frequency of

heparin, and found the same result as he did with the dilution of the actual heparin. He also found

that the robotic device made to silence his critics regarding the potential bias of human

interference was somehow responding to people. He realized with some testing that it was the

water vial held by the robot that was affected by the proximity of various people. One fellow

scientist seemed to negate any “energy” in his homeopathic vials when exposed to them, while

another worker restored the potential for the vial in the robotic device with the test results being

restored to consistency after his holding the vial for some time.108

107

Davenas E, Benveniste Jet al. Human basophil degranulation triggered by very dilute

antiserum against IgE. Nature, 1988Vol. 333, No. 6176, pp. 816-818 108

Gerber R. Vibrational Medicine for the 21st Century Piatkus, 2001. p403-409


This energizing of the water seems to link in with the experiments of Bernard Grad discussed

earlier.

Benvenistes work was confirmed by Nobel Laureate virologist Luc Montagnier in 2009.

Montagnier also demonstrated that homeopathically prepared bacterial and viral DNA could

transmit information via electromagnetic waves through water.109

J. L. Sudan, a Swiss researcher used a homoeopathic high dilution of tobacco to treat his familial

facial seborrhoeic dermatitis induced by the hapten nicotine. He performed a double-blind

experiment against placebo and did several treatments with continuous and single intakes of

tobacco in high dilutions. After some time, this led to a abrogation of dermatitis, simulating a

desensitization. These observations provide a new possible explanation for the placebo effect and

facial seborrhoeic dermatitis is proposed as a new visible model for Benveniste’s theory of

‘Memory of Water”. 110

Reilly et al in the Lancet confirmed a similar latent response to pollen allergens.111

Some recent work in India has also confirmed Benveniste’s later work with the electronic signal

of homeopathics in two medicines of the same potency and two different potencies of the same

medicine. Arnica Montana 30c, 200c and Anacardium Orient 30c, 200c were the substances

tested. These potencies are well above the Avogadro limit. They found definite differences in

both the response due to substance as well as strength. Their investigations reported the concept

of ‘induced molecular structure’ advanced by a number of scientists. Dielectric dispersion is

based on the fact that when the exciting frequency of the applied electric field equals the

characteristic frequency of the macromolecule, then the macromolecules resonate, leading to

anomalous dielectric dispersion associated with sharp increase in dielectric loss. The resonance

frequencies being different for macromolecules of different structures or dimensions. This was

used as the tool for experimental testing. The results suggest that medicine-and potency-specific

attributes are acquired by the vehicle (i.e. water) in the form of macromolecules generated by the

109 Montagnier. L. Autobiography. Virology. 397 (2010) 243-247 110 Ref Medical Hypotheses (199341). 44a-444 a Longman Gmup UK Ltd 1993 Abrogation of Facial Seborrhoeic

Dermatitis with Homoeopathic High Dilutions of Tobacco: A New Visible Model for Benveniste’s Theory of

‘Memory of Water’ 111 Reilly, D T; Taylor, M A; McSharry, C; Aitchison, T. Is homoeopathy a placebo response? Controlled trial of homoeopathic potency, with pollen in hayfever as model. Lancet Vol 2 issue 8512 p 881

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22Reilly%2C+D+T%22

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22Taylor%2C+M+A%22

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22McSharry%2C+C%22

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22Aitchison%2C+T%22

http://queensu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV1NS8MwGA4iKLv4PfyE97ST0zbNkhTGhgyHHrzNi5eRLCkdzLZuE-zF326-NlTm0WPbtDRN0jxv8rzPY9OAk06UCaao6RAGjdCUmUOh00Sa_6TWvzP4Vxzd8PEWG8M66yX1PJ_dfLzV_dVKWOCth2GMW_5NDYTALT8aucvJThh3KpMveFPCpHtGA-1gK81mJRZ-oEs3ywz30edam9ByS4IPxUbtxn-pxQHaC_gU7nyHOkRbujhCu09hB_4YLR8XkJevpS6tl3ENAhyrS5Yw92xb3YeBp7_PtAJnCgJl9u2e6QSq0iL1-hrsKjB0815lSxfd27wH0wJyUWfaDDEQC3BOPSdoNLwfDR7awbmhXZFO3BYi05gwQVksJKcpjjKS6JRjZUAy0SwiGkvOM04mdvc8xSZmUyZUlioy5wyAaKLtoiz0KQKqpIGcpqwgBrgRJpUkEiurK8cpo-QMNX17jSuvzjEODXn-14UL1IhTTu38E_NLtL2cv-urtbfIF3IZ0Rc



potentiation process of homeopathy which makes one medicine structurally different from

another.112

Homotoxicology

In the study of homotoxicosis, a branch of homeopathy, they speak about 6 stages to disease:

Humeral Stage 1. Excretion

2. Reaction - ie reactive hypoglycaemia

Matrix Stage 3. Deposition - ie NASH syndrome, central obesity

4. Impregnation - ie metabolic syndrome

Cellular Stage 5. Degeneration - ie diabetes mellitus type II, osteoporosis

6. De-differentiation (neoplasm) - ie colorectal cancer, breast cancer,

myeloma, pancreas cancer

The humeral stage is the environmental imprint, the matrix phase is a failure of regulation and the

cellular phase creates a phase shift. It is clear that water has involvement on the cleansing of the

tissue, as the extracellular waste products, or ingested toxins are all removed by the water

apparatus. It is commonly considered that the best way to flush toxins is through “drinking plenty

of water”.

It is currently understood that to drink lots of water away from foods is to enable a good enough

fresh supply of unbound water to irrigate the ECM and the cellular interstitium This will ensure a

ready supply for the exchange of fluids that occurs all day long.113

112

Mahata, CR. Dielectric dispersion studies of some potentised homeopathic medicines reveal structured vehicle.

Homeopathy. Volume 102, Issue 4, p. 262

113 Smit, A. Homotoxicology: Bridging Naturopathy and Pathophysiology in your Practice. Course reference. 2004

http://queensu.summon.serialssolutions.com/search?s.dym=false&s.q=Author%3A%22Mahata%2C+C+R%22

http://queensu.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwtV07T8MwELZQB8TCu1Be8tQtKLGdpJ4QAiqWbnQuju1AJGhKUxD8e-5sp6KojIzRJbZyvnO-i7-7wzRgnsalyk0GBgFoJJM5XCoreQH7pLW_M_hb7nxQXrM2rMNeUuP5y-Xn29eV91SRp5EAcNNv3Thm_SoEqMEZ3d7M8xStfSSW1A-sqSZd1lEYIiTTeN4X8jCQ8sVdUU9sphX26hXY6T4_wx3S0q086SQ0qFhb1PE_Xm-XbAfcSq-9oe2RDTvdJ5ujcDJ_QB5vK99Rp9LUVFh-HH_D0cbTFGld0qZ-tXRWL5Ce1FhDQQO2dg2RNW1P-BuKFaVgHl_W9n0O933YZ5zykIyHdw8391Ho3hA9JRDERKkF7JdZI7RiGReyKFVsFTe5dChLMz0QWmcqVni2qLkySaY5kybRIGMJ75LOtJ7aY0IBY5pBaYwoCyNSZZSIrdQySUtWIIDpkQtcoolPHV367IRDrCuFzFmPHLkbUNeLudI_JV0nmfnaHiuP-PVeigD7AHjO2cmfg52SLTQcz_U7Ix1QlT1fti35BlNH7Rg



The discussion on homeopathics is here for two reasons. One, the potency of the water is of

interest to us. As we work with the fluids of the body it is perhaps good to think of the power that

it has inherent within. The other reason is to perhaps think that it is sometimes of use to consult

with other health care practitioners who may have some assistance to offer with the quality of the

patients tissue and their response rate. It has been noted by many practitioners that the quality of

the tissue of the patient in an indicator of the speed of recovery. Anything that will help with a

better quality of health and energy in the tissue is of benefit in our practice, just as drinking more

water to help hydrate the tissue is important.

10.5 Infrasound

Infrasound is characterized by an ability to cover long distances and get around obstacles with

little dissipation. As water propagates waves readily, it is of interest to examine any influences

that infrasound may have on our body tissues.

Sound waves cause vibration of the tympanic membrane of the ear. This is then transmitted to our

inner ear bones which vibrate in turn, moving fluid on membranes in the inner ear to create a

shear on the small hairs in the inner ears. This then stimulates neurons which are translated into

sounds in our brain.

Sound is described by amplitude (loudness) and frequency (tone). The human ear can hear

frequencies of 20 – 20,000 waves per second or Hertz (Hz). Infrasonic waves are those at lower

than 20 Hz. The human ear can detect sound at as low as this frequency, but hearing becomes less

sensitive as frequency decreases 114

For humans to hear this, the sound level must be high. The

ear is the primary source for our recognition of sound waves, but at higher intensities, it is

possible to feel infrasound vibrations throughout the body. This corresponds to feeling a bass

drum in a band going by, a church organ, or a car with a loud bass driving by, thumping

everyone’s walls in the vicinity. (This occurs because most construction materials have low-

resonant frequencies so low frequency waves set up sympathetic vibrations.)

114 Marieb E. Human Anatomy and Physiology pp584-589

http://en.wikipedia.org/wiki/Dissipation


Infrasonic Concert Experiment

Professor Richard Wiseman presented results from an infrasonic test concert to the British

Association for the Advancement of Science. A concert series was set up in England in 2003, in

which approximately 700 people listened to music. At each of the two concerts, two pieces of

music were laced with undertones of infrasound at 17Hz. The two pieces were different each

concert. The subjects were then asked to record their emotions on each piece. It was considered to

be a blinded study.

The presence of the tone resulted in a significant number (22%) of respondents reporting anxiety,

uneasiness, extreme sorrow, nervous feelings of revulsion or fear, chills down the spine, and

feelings of pressure on the chest. This suggests that some people can have unusual experience

despite not consciously detecting infrasound. 115

Animals communicate via infrasonic waves. Rhinoceros and elephants are among the best known

and tested, with some of their vocalizations well below 10Hz. Elephants have been studied to see

if their vocalizations propagated seismic Rayleigh waves which propagate equally in all

directions. Acoustic waves attenuate more rapidly upwind than downwind, so the relative

locations of the vocalizing and the receiving elephants could preferentially facilitate seismic

communication in one direction. They were found to be able to communicate up to 10km with

their low frequency vocalizations.

In a study by Onu et al, it is emphasized that the otolith organs in fish are like linear acceleration

detectors. They are extremely sensitivity to infrasonic particle acceleration. Near-field particle

motions generated by a moving hull are mainly in the infrasonic range, and infrasound is

particularly potent in evoking directional avoidance responses in several species of fish. As we

have seen, animals have awareness of infrasound. Contrary to expectations, the avoidance

reactions evoked by the “stealth” vessel were stronger and more prolonged than the responses

initiated by the conventional vessel.116

115 https://sites.google.com/site/appliedbiophysicsresearch/sound/infrasound 116

Sand O, Karlsen HE, Knudsen F. Comment on Silent Research vessels are not quiet. J Acoust. Soc AM 121

EL145-EL150.

https://sites.google.com/site/appliedbiophysicsresearch/sound/infrasound


Otolith organs in the inner ear of fish behave as nearly critically damped mass loaded

accelerometers. They are thus inherently sensitive to the kinetic sound component (particle

motion), and not to sound pressure.117

As fish also have a swim bladder they may also be sensitive to sound pressure. However the

otolith organs remain sensitive to particle motion. When a volume of gas is exposed to oscillating

pressure changes, it will display larger volume pulsations than a comparable volume of water. In

a sound field, the radial motion amplitudes of the surface of a gas-filled bladder may therefore be

larger than the water particle motions in the absence of the bladder. This may explain some

factors why fish avoid boats.118

This is why there is such an outcry for research sonar testing by

Navies, as it is disturbing to marine life with their communications and migrations patterns. Some

wave exposure attracts them while others frequencies seem to send them off course. It is not

known if this is a conscious response or unconscious, therefore there are implications to this for

humans as the innate frequency of our brain and heart are in the same low frequencies.119

Seismic recordings measure low frequency waves set off in the earth by earthquakes and are

registered at stations that record the waves, and triangulated to find the locicentre and intensity of

the quake. Infrasonics are low frequency waves sent through water and air. Prior to earthquakes

and tsunamis animals leave the vicinity. This may be due to the low frequency waves felt by the

animals

The infrasound of seasonal winds and weather patterns produces illness in certain persons.

Mistral winds are well known to disturb local’s health and mood when they blow. Physiological

changes have been noted for centuries.120

There is currently a patent out for a low frequency vibration assisted blood perfusion emergency

system.121

117

Chapman CJ, Sand, O. Field studies of hearing in two species of flatfish Pleuronectes platessa (L.) and

Limanda limanda (L.) (family pleuronectidae) Comparative Biochemistry and Physiology - Part A:

Physiology47(1) January 1974, Volume47(Issue1) Page p.371-385. 118 Sand O, Karlsen HE, Knudsen F. Comment on Silent Research vessels are not quiet. J Acoust. Soc AM 121 EL145-EL150. 119 https://www.heartmath.org/programs/emwave-self-regulation-technology-theoretical-basis/ 120 Green JE, Dunn F. Correlation of Naturally Occuring Infrasonics. J of Acoust Soc Am. 1457

http://journals2.scholarsportal.info.proxy.queensu.ca/browse/03009629



https://www.heartmath.org/programs/emwave-self-regulation-technology-theoretical-basis/


It is evident even in our own experiences that we feel low frequency vibration. However, there

are few studies on the effect of low frequency vibration on the human body. This has led to much

confusion and misinformation regarding the effects of low frequency waves from wind turbines

on the effect of people living nearby. There is much documentation anecdotally of people having

various health problems, which may stem from simply sleep deprivation, but thinking laterally,

may be much more. The wind turbines generate audible waves with a frequency greater than

20Hz, but also large amounts of sound waves below 20 Hz and wind proponents say that as they

are basically inaudible, they are of no concern. However, as we know that animals and people

have responses to these low frequency waves, this may be of concern with long term exposure.

Waves have propagation relative to their pathways. For example, consider how a breakwater at a

beach works. If the opening is large enough, the waves pass through. When there is a smaller gap,

the waves are reduced and redirected.

Imagine the infrasonic waves entering your window and redirecting though all the other

doorways in your house while you try to sleep. There would naturally be a lot of acoustic

resonance.

Studies of CSF pressure have used the cochlear aqueduct connecting intra-labyrinthine and

cerebrospinal fluids (CSF) to act as a low-pass filter to transmit infrasonic pressure waves from

CSF to cochlea. This was used in recent experiments demonstrating that oto-acoustic emissions

generated at 1 kHz respond to pressure-related stapes impedance changes with a change in phase

relative to the generator tones, and provide a non-invasive means of assessing intracochlear

pressure changes.122

121 United States Patent Application Hoffman Pub No US 2008/0287793A1. Appl No 11/807.368. Low frequency

vibration assisted blood perfusion emergency system.

122 Traboulsi R, Avan P. Transmission of infrasonic pressure waves from cerebrospinal tointralabyrinthine fluids

through the human cochlear aqueduct. Hearing Research 233 (2007) 30-37


Transmission of hydrostatic or infrasound pressure from the CSF spaces to the cochlea may have

an effect on hearing. Increased static intracranial pressure (ICP) has been reported to affect the

outcome of audiological tests.123

Changes in ICP of comparable size can be induced by either a change in posture or a

neurosurgical condition leading to transiently or permanently raised ICP.124

Other studies have used the tympanic membrane to moniter the infrasonic waves from the CSF.

125 As researchers are using infrasound waves to study the CSF though the ear, imagine the effect

on the body of these waves entering at all hours of the day. It may be reasonable to think there

may be an effect on people living in proximity to these turbines.

A study in Poland on low frequency vibration of the whole body showed that frequency is the

most critical parameter in propagation of vibrations on the human body. Vibrations below 12 Hz

were affecting the entire body, while frequencies above 12 had only a local effect when

measuring vibration acceleration at various levels on the spine. 126


The human body is comprised largely of water. Vibrations, especially those at a low frequency

appear to have an impact on the fluids in the brain and ear. We know we feel them in our thorax

with different drums and music. An understanding of this may help if patients have been

chronically exposed to specific frequencies. This is a relatively new area of research and it may

prove interesting as waves propagate so readily in water.

123

Phillips AJ, Farrell G. The effect of posture on three objective audiological measures Br J of Audiology26(6)

January 1992, Volume26 (Issue6) Page p.339-345 124 Traboulsi R, Avan P. Transmission of infrasonic pressure waves from cerebrospinal tointralabyrinthine fluids through the human cochlear aqueduct. Hearing Research 233 (2007) 30-37 125

Stettin E, Paulat K, Schulz C, Kunz U, Mauer UM. Noninvasive Intracranial Pressure Measurement using

Infrasonic Emissions from the Tympanic Membrane. J of Clin Monit and Comput. (2011) 25:203-210 126Zagórski J, Jakubowski R, Solecki L, Sadlo A, Kasperek W. Studies on the transmission of vibrations in human

organism exposed to low-frequency whole-body vibration. Acta Physiol Pol. 1976 Jul-Aug; 27 (4):347-54.



http://www.ncbi.nlm.nih.gov/pubmed/?term=Zag%C3%B3rski%20J%5BAuthor%5D&cauthor=true&cauthor_uid=983715

http://www.ncbi.nlm.nih.gov/pubmed/?term=Jakubowski%20R%5BAuthor%5D&cauthor=true&cauthor_uid=983715

http://www.ncbi.nlm.nih.gov/pubmed/?term=Solecki%20L%5BAuthor%5D&cauthor=true&cauthor_uid=983715

http://www.ncbi.nlm.nih.gov/pubmed/?term=Sadlo%20A%5BAuthor%5D&cauthor=true&cauthor_uid=983715

http://www.ncbi.nlm.nih.gov/pubmed/?term=Kasperek%20W%5BAuthor%5D&cauthor=true&cauthor_uid=983715


91 CHAPTER 11: OTHER ASPECTS ABOUT WATER STRUCTURE

11. OTHER ASPECTS ABOUT WATER STRUCTURE

11.1 Dr Emoto - Images of water crystals

Dr Masuro Emoto is a Japanese water researcher, who after being introduced to the concept of

micro-cluster water by Dr Lee Lorenzo of the USA, begins to research the effect of water. He

discusses the frequency of the cells of the body, and the link with health and cells vibrating

harmoniously. Emoto used a MRA (magnetic resonance analyzer) which he acquired through Dr

Lorenzo. This is a machine that measures Hado, which he describes as the intrinsic vibrational

pattern at the atomic level in all matter, forming the basis of the energy of human consciousness.

It can be thought of in terms of vibration and resonance.

The devise he used had a forerunner in a device from Dr Harold Saxton Burr, a renowned

professor of anatomy at Yale University.127

Dr Burr had researched the L-field or life field, and

measured electrical voltage in the body with emotional changes, mental health problems and

injuries.128

Emoto discovered that water is extremely sensitive to hado; or the vibrational emotions, whether

expressed verbally, in a written form, or musically. The different stimuli create different

responses in terms of the beauty and regularity of the water when it crystallizes at the freezing

point. The resultant water crystals demonstrate a geometrical design shaped by that specific

vibration. He found that the type of crystal and its symmetry is related to the harmoniousness of

the vibration. Emoto captured images of these crystals with high speed photography.

Dr Emoto compares emotions, and feels that based on the vibrations of emotions, the opposite

emotions must be used to cancel the vibration of any negative emotion.

He did some interesting mass experiments such as one performed on a very polluted lake in

Japan. Approximately 350 people were gathered at the shore of Lake Biwa in 1999 to attempt to

cleanse the lake. One month later, the lake did not develop the putrid smelling alga as it usually

127 Emoto M. (2005) The Secret Life of Water. Atria Books. P 139

128 Burr, H. Blueprint for Immortality: The electrical patterns for life, 1972, p.17.


did at that time of year. Emoto concluded that the harmonious chanting helped regain the health

of the water. He has done other experiments to cleanse

polluted water and also to cleanse water from negative

emotions by replacing the stimulus with the opposing

positive stimulus with the results of beautiful crystals

forming where previously there were deformed ice shapes.

Figure 44 Water exposed to the word Love

Figure 45 Water exposed to the words You are Beautiful.

Figure 46 Comparison of effects of healing music and hurtful emotion.

Other photo references can be found in the appendix section. The above photos are from the

internet along with many more.



Osteopaths are sensitive to differences in tissue quality. When treating a patient, it is important to

bear in mind that water quality can be affected by emotions. This may make a big difference in

the tissue response to treatment. The water quality from emotions can therefore make a big

difference in the tissue response to our work. If we can utilize this concept in our treatment, the

quality of the fluids in the tissue could also improve. It would also be important to reassure and

educate our patients so they have a better understanding of their health, and feel enabled to

participate in their healing. If they understand why something has happened, there is less anxiety

and this may improve their healing.

It is also important for the Osteopath to take care, as any emotions or occurrences in their own

lives will have an effect on their own tissues. It is important to be centred while treating and not

pass on any tensions to the patient from the operator.


11.2 Cluster Water

The structured water referred to in chapter 4 is part of ongoing work since the 1960s from

researchers seeking to understand the behaviours of water both at surfaces and in colloids.

Light refraction studies done by Gerald Pollack in his lab have demonstrated different light

absorptions properties of water when light passes through the water at different distances from a

specific boundary wall.

It was demonstrated that there were different l light absorptive qualities depending on the

distance from the side wall of the container.

Substances differ in how they absorb light, as seen by astrophysicists studying the make-up of

stars in space. This experiment demonstrated that water was somehow different near the border of

the container. This area of different characteristics has been called exclusion zone (or EZ)

water.129

When electrodes are used to test the charge of water along the border of various containers, the

charge varies at different distances (in terms of μm) from different wall surfaces.130

Magnetic Resonance Imaging (MRI) uses the principle of water`s character differing in different

environments to visually image the different excitation and relaxation of water in tissue studied

after being subjected to a pulsed magnetic field.

If the above mentioned zone is more negative, that means in pure water, there must be a region

more positive, more proton filled, and this has been demonstrated in lab work. PH testing proves

to be higher in the non-exclusion zone region.

129 Pollack, Gerald (2013) The Fourth Phase of Water – Beyond Solid Liquid Vapor. P 35

130 Ibid p 34


Around the world, there are many spas with water. Germany is renowned for their medical spas

with water treatments. There are also many famed healing springs, such as Lourdes, where people

claim miraculous results from bathing in the waters. The Dead Sea with the heavy salt and

mineral concentration is popular with people seeking healin. We all know water is enjoyable on

many levels, and we also understand the placebo effect.

However, these waters may be much more than that. There are researchers now studying this

water, to see if there is something special. They are looking at the structure of the water, as

Emoto has done. They are finding structures in certain water that have structure without being

frozen. This water appears to have different characteristics from normal water.

Some of these waters appear to line up in hexagonal clusters due to their electron sharing

activities discussed in Chapter 4. This effect is soon lost when water is transported away from the

source. The clustering in a hexagonal, or honeycomb, shape imparts a different net charge from

non-clustered water.131

The different qualities water exhibits by changing barriers may be interesting in terms of the

chemistry of biological systems. Intracellular fluid and extracellular fluid interactions may be in

part regulated by the water qualities in larger ways than suspected. Much more study is needed in

this field to better understand perhaps the implication of the characteristics of water around

macromolecules in the ECM of the body.


This research could be very interesting for us to better understand the thixotropic characteristics

of the fluid movements under the hands of a trained Osteopath. Thixotropy is not generally well

understood, but it`s principles are used greatly in our work. The characteristics of fluid flow and

cleansing in the body are of prime importance to health. If the structure of water can be improved

though quality of drinking water or the movement of the water, this could impact the quality of

our treatment results.

131 Pollack, Gerald (2013) The Fourth Phase of Water – Beyond Solid Liquid Vapor. Pp56-63


11.3 Aging

"The idea that 'dirty brain' diseases like Alzheimer may result from a slowing down of the

glymphatic system as we age is a completely new way to think about neurological disorders."

Maiken Nedergaard, brain researcher.

The discovery of the glymphatic system presents new opportunities to study how to improve the

clearance of metabolites from the brain and potentially change the course of conditions such as

Alzheimer’s Disease (AD).

In reference to the topic of this paper, dehydration in aging with the consequent decrease in tissue

quality may have many components to it. In older adults, lower muscle mass, reduced kidney

function, physical and cognitive disabilities, blunted thirst, and polypharmacy all increase

dehydration risk. As yet, it is difficult to detect early signs of dehydration to maintain osmolality

in elderly tissues. Studies suggest that the prevalence of dehydration in this population is 20-30

percent. This is associated with higher mortality, morbidity and disability in older people, but

evidence is still needed that this relationship is causal. There are a variety of ways we may be

able to help older people reduce their risk of dehydration by recognising that they are not

drinking enough, and drink more. Strategies to overcome barriers such as continence concerns

and the mobility to easily access a toilet are among the issues possibly affecting intake. It is

important to identify and try to rectify any issues that may lead to a decrease in hydration in the

aging population.132

132

Hooper L.; Bunn D.; Jimoh F.O.; Fairweather-Tait S.J. Water-loss dehydration and aging. Mechanisms of

Ageing and Development, Volume 136-137, Pages 50-58

97 CHAPTER 12: DISCUSSION AND CONCLUSION

12. DISCUSSION AND CONCLUSION

12.1 Discussion

Water, with its solvents, is clearly important in the body. In Osteopathy much emphasis is placed

on the fluids. “The rule of the artery” is one of the fundamental principles of Osteopathic

treatment.

The mobilizing of the fluids entails having a good basis of understanding of its structure and

components in order to maximize our effect in this important role we play in dissemination of

fluids.

The Osteopath does not need to think of the hydrodynamic equations of fluid flow while

practicing. Nor is there a necessity, or even possibility of understanding the details of the myriad

of the biochemical interactions involved in the minutiae of metabolism, homeostasis or even the

function of the musculoskeletal system. However it is important to comprehend some of the bases

of these movements.

When for example we do volumetric work on a body, we are working with the tissue so well

demonstrated by Dr JC Guimberteau. We should be able to visualize these fibre strands and the

water as we work.

Thixotropy is the flow caused by mechanical deformation from our hand on a person’s tissue.

The wave of movement created by our hand affects the movement of fluids in the extracellular

fluid and thus is also important for regulation of the environment of the cell.

Osteopaths work in complexity, viewing the body as unit. The body’s functions interact and re-

interact, always in a state of flux. We listen with our hands and use our education to determine

where the root of the dysfunction lies. We listen to the tissue through the liquid crystal matrix of

the body. We feel the “energy” of the tissue, like a cell battery. Perhaps we feel the “energy” of


the tissue like a cell battery. Perhaps we may be feeling the energy storage occurring though the

cation pumps and the vibrancy of the metabolism occurring at the cellular level.

Basic electrical charges of the elements involved in our molecules contained within are of critical

importance in our bodies. These charges are the basis of the molecular formation. It is interesting

to note

that naturally occurring proteins and amino acids are all left rotating helixes, while sugars are

right rotating. Synthetic amino acids and sugars form 50/50 right and left rotating. Something in

the body must be responsible for this.

The loss of an electron in the cloud around an element or molecule in solution can create an

oxidized structure. This can subsequently create disturbances in other molecules, as well as

changing the structure of cell membranes. (This is why we are told to eat foods with anti-oxidant

properties.)

It is evident that if the chemistry of our body fluids is off, many things can change and a domino

effect takes place. Better movement of fluids will decrease this effect by clearing away oxidizing

factors such as free radicals.

The cellular exchanges that occur by way of electric charges, such as the sodium/potassium

pumpalso are responsible for depolarization of nerve cells. This rapid exchange of ions across the

cell membrane requires a fluid medium surrounding the nerve. Fluid within the nerve, bathing

both the fibres and the surrounding sheath, is critical to propagation of nerve conduction.

Osteopathic treatment can help not only with the fluid movement, but also electrical activity from

the hand of the therapist will ameliorate the changing polarity of the cells.

With thixotropy, as the tissue is sensitive to temperature and pressure, it is poissible for the

therapist to affect the movement of the fluid in the tissue, assisting with movement of solutes,

molecules, cells and fibres contained within. This also enhances cellular interchange- both in the

cells in the interstitium and in the “walls” of membranes and vessels. With this change of


resistance of movement, we can affect the consistency of the tissue: change the resistance of the

tissue. This is important as stress, aging, dehydration and injury all increase the resistance of the

tissue. As the tissue becomes less resilient, this can lead to stasis and disease. We can help to

change this with our hands on treatment, to improve the fluid flow, resiliency and drainage of

tissues and move towards a healthier state.

As mentioned, electricity powers the activities of the body. It sends information, gives orders and

converts information into action. All the biochemical transactions occur due to electrochemical

charges. The medium of the water enables these electrical transactions, as evidenced by its

conductive qualities due to the nature of the molecule.

We know there are electromagnetic forces in the world. It is well documented that the human

hand has an effect on the body. It is difficult to determine the exact effects of the therapeutic

placing of hands. Electromagnetics, thermal input, and thixotropy are all factors in the tissue

response. However, the net influence is by the fluid activity, whether by movement or electro-

chemical changes in the tissues. The effect of electromagnetics in the brain is interesting; as there

is much brain research currently occurring in the field of sports concussions. The results of this

research may be able to assist our understanding of the effect of hands on treatment.

In the treatment methodology of “doing nothing” (the slang for waiting for a working with the

long tide) there is an effect though thixotropy and metabolic stimulus, as well as electrochemical

or electromagnetic changes. This is a powerful treatment methodology, beyond what a lay person

would expect.

More specific work, such as volumetric work, using asymmetrically placed hands to work a fluid

lemniscat is a more dynamic method. This can help to reorganize “stuck” fluids and small

parasitic tension in the body with a fluidic wave.

Fascial treatment is work done, not to stretch tissue, but to improve its quality. The goal is to

improve resiliency and hydration, to return it to a more original state. Working with a view of

embryology and the forces shaping ontology is of prime importance, to truly know the directions

of development.


When working the venous circulation, it is important to remember that these thinner walled

vessels are very efficient to treat. They are more easily compressed than arteries, but as they are

compressed to help move the fluid, they “pull” the arterial blood to fill the vacuum created by

their outflow. Venous work is done in an upstream-downstream compression and release to use a

negative pressure to pull the fluids.

Lymphatic node pumping has a similar methodology to the venous pumping. Any pumping

of the nodes expresses the lymph which helps to draw the fluid from the afferent vessels.

Like veins, the lymph vessels have valves to prevent back flow. However, clinically, it has

been noted by the author that any lymphatic work will give you a good indication of other

restrictions in the body. Apparently, increased flow from one region restricts free drainage

from an area that has some compromise. This leads to a back-up and pain from the distension

of the lymph system. Thus it is usually best to clear the downstream junctions prior to

peripheral work. As symptoms arise from lymph mobilizing, those areas must be addressed

before they become too intense.

The lymphatic system appears to act as a type of “semi-closed hydraulics” where each area

will affect the others. All 4 quadrants as well as the head and breast region can be affected in

this way. Treating the underlying ribs significantly helps to drain the congestion in the breast

lymphatics.

The Glymphatic system in the brain can be worked along with the treatment of the venous

sinuses, as it drains alongside the major veins of the cranium. The Osteopath’s attention is just

slightly different. In addition, it is important to assist with the drainage through the jugular

foramen and the beginning of the external venous drainage. This helps ensure the easy exit of the

glymph into the lymphatic system.


The health of the glymphatic system is paramount, involved possibly with Parkinsons, traumatic

brain injuries, Multiple Sclerosis, and inflammatory conditions. I may go out on a limb and

personally wonder if a lack of easy glymph/lymph drainage from the exit points of the skull can

be used to explain some people being non-morning persons; they need to wait until these fluids

drain to feel properly awake.

In light of the research of Ilich and Nedergard (Section 8.2) it is also interesting to speculate if the

cellular reduction in the brain during the sleep cycle also occurs in the body with the slowing of

metabolism while sleeping. Some years ago, the British nurses won retroactive “danger style

pay” for the increased risk of cancer with their shift work. This extracellular cleansing is of prime

importance to health. In Osteopathy, we frequently speak of the problems created by decreased

mobility leading to stasis and subsequent degradation of tissue from lack of circulation and

cleansing, leading to disease. Further research would be interesting to test this hypothesis.

The cranial ventricles can be important to treat for the health of the whole body. Movement of

the fluid though the ventricular system, irrigation of the spinal cord and peripheral nerves and the

regulation of pressure changes in the cranial vault are all critical issues. Also, the protective

cushioning of the CSF and its ability to spread and dissipate force in case of trauma is very

important.

Maintaining good movement of the cranial ventricular system is important for the whole energy

of the body: the battery juices of the CSF/ISF.

The Stillpoint has been referred to as a cessation of ventricular flow by some, however this is

unlikely given the dynamics of the ventricular system and its components The sense of stillness is

more likely due to a relaxing of the tensile structures around the system, such as the reciprocal

membranes in the cranium and the subsequent adaptations this relaxation can bring. This is

confirmed by the writings of WG Sutherland and Rollin Becker.


Fasciae, in relation to the pericardium and myocardium, as well as in the renal system, are of

course also important to treat in terms of fluid mobility and their respective functions. Thinking

of the heart as a negative pressure pump may be helpful while working, to think of the

importance of the drawing in of fluids and the maintenance of the mobility of the vessel walls as

they enter and exit the mediastinal region. As in all tissues, ensuring a good freedom of mobility

and free circulation is of key importance to allowing full function of these essential structures.

That doesn’t need to be further emphasized as the failing health of these systems quickly leads to

life-threatening emergencies. We can do much to ensure no lack of restriction to the surrounding

fasciae and the circulation, as well as a good motility of the tissues.

Respiratory exercises also have an effect of the fluids, with an increase in pressure in the lungs

leading to more oxygen in the blood creasing a greater fluid flow returning to the heart as well,

creating a domino effect to the tissues. Improved respiration not only mobilizes the ribs as

mentioned earlier, but also helps with the mobility of fluids, with the change of intra-abdominal

pressures assisting with the drainage of venous blood and lymphatics against gravity as they

return cephalically.

Water movement is inherent in almost every function of the body. Any work to increase its

mobility has great effect on the tissues. Having a better understanding of how we can best

influence fluid flow in the body can be of great help in terms of treatment. Sometimes we need to

“de-magic” the work we do, so as to better explain the effects of Osteopathy to our patients and

other health care practitioners. Un-esoteric explanations can be very useful to improve

communications and compliance with our treatment and the understanding of the reasons for

what we do. It can also help to improve patient compliance, when they truly understand how any

prescribed exercises may help compliment their Osteopathic care, ensuring a better maintenance

when they are discharged.


Case Study of Patient with Pheochromocytoma and Takotsubo

Cardiomyopathy

The importance of fluids was very clearly brought home to me with an urgent request for help.

The patient was a 40 yr old female. Surgery for a torn anterior cruciate ligament had resulted in a

previously unsuspected pheochromocytoma making its presence known. She experienced a

cardiac arrest from a Takotsubo cardiomyopathy), with subsequent shut-down of the liver,

kidneys and lungs, culminating in paralysis of almost all muscle function. Some eye and mouth

movement and very low grade neck rotation was left. Nerve conduction tests had recently been

done. The results showed no peripheral nerve axon transmission.

On researching this extremely rare condition, Takotsubo Cardiomyopathy, I discovered that one

possible cause of the cardiac arrest was compression of the cardiac vessels secondary to spasm.

Please view the appendix for the other possible causes, and more details on this condition.

I immediately questioned whether this may have been caused by a type of “sympathetic storm”

which could also therefore have affected the vaso-nervorum of the peripheral nerve roots. The

immediate question to be asked was if a lumbar puncture had been performed to measure the

pressure in the cerebrospinal fluid in the spine. The answer was an emphatic yes. It was 34 cm

H2O. Normal levels are between 20-24 cm H2O.

On evaluating the patient, the pressure at the level of the spine was readily palpable, and this was

further confirmed by later viewing the reportedly normal MRI of the spine (please see scans in

Appendix 5). The fluid pressure discernably distended the cervical spine, showing the mal-

alignment of the densities of the bony and soft tissues . The patient had been paralyzed with no

progress for 3 months. Within 10 days of Osteopathic treatment focused on improving fluid

movement at the level of the nerve roots and perivascular sheaths, muscular activity was seen and

has continued to progress. She can now sit independently for several minutes and self-correct,

and is eating a full diet, however still required feeding. As fluid is incompressible, it has great

power. The power of the fluid to dictate mobility is very strong, and without awareness of this,

Osteopaths cannot be as effective as needed.


12.2 CONCLUSION

Osteopathy is based on a holistic approach. We are taught to look at the ever changing milieu of

the body and its emergent behaviours.

When we touch the body with our hands, we must be aware that we are touching the entire body.

Tissues have Tensegrity, from larger fasciae to cell membranes and this tensile force spreads

from our hands. Fluid is incompressible and has a great power. We need to better understand our

role in assisting its movement through the surrounding structures to better the health of our

patients.

As Osteopaths, there are many different methodologies we have been taught, and have developed

over the time practicing. It is important to know which tool to choose from the toolbox to work at

the level that is required. There are many choices in terms of working with the fluids, depending

on which level in the complex unit of the body we need to most emphasize.. The heart and the

arteries must bring oxygen and nutrients to all the tissues. The venous drainage, the lymphatics

and the glymphatics are necessary to rid the body of toxins. They all work together to bring the

cellular metabolites to the kidneys for them to fulfill their role. We are fluidic bodies, and need to

remember this when tempted to think too structurally. Could I say - The rule of the “fluids” is

absolute!?

Movement is life, and the fluids are of prime importance in this movement. We must continue to

further our knowledge of stimulating health.

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GLOSSARY

Anecdotal based practice – In opposition to the Cartesian evidence-based practice (see below),

it uses a broader scope by use of practical experience of the individual and of others through

shared anecdotes. An anecdote is a story – in the context of medicine it often relates to an

individual’s experience with their disease or symptoms and their efforts to treat it. People

generally find anecdotes highly compelling, while scientists are deeply suspicious of anecdotes.

This doesn’t mean that it relies on old-wives-tales, but that is will trust to logic and experience

over statistics. Remember, statistically speaking, everyone has one breast and one testicle.

Avogadro limit – in biochemistry – is a point—based on Avogadro’s number, 6.02 X 1023,

which represents the number of molecules in a gram-molecule—at which a homeopathic remedy

has been diluted/attenuated where it is unlikely that any molecules of the remedy are present.

Biodynamics – (from the website of the James Jealous courses) Biodynamics is set upon the

therapeutic powers of the Dynamic Stillness, the Breath of Life, the tidal potency, fluids and

other Natural Laws at work supporting and generating life. The techniques are taught with

full cooperation with the composite of the Living Mechanism and its intention within the

moment. It is not about bones, or levers, or palpation. It is not about balanced membranous or

ligamentous articular tension; these approaches are a different composite. It is about the Tide at

work as the primary source of diagnosis and treatment with no application of force to Osteopathic

lesions or psycho-emotional systems.

Blood–cerebrospinal fluid barrier is a pair of barriers that separates peripheral and cerebral

blood flow from the cerebrospinal fluid (CSF); it is composed of epithelial cells of the choroid

plexus at the peripheral blood–CSF boundary and the arachnoid membrane at the cerebral blood–

CSF boundary. The blood–CSF barrier serves the same purpose as the blood–brain barrier, but

facilitates the transport of different substances into the brain due to the distinct structural

characteristics between the two barrier systems.

http://en.wikipedia.org/wiki/Cerebrospinal_fluid

http://en.wikipedia.org/wiki/Epithelial_cells

http://en.wikipedia.org/wiki/Arachnoid_membrane

http://en.wikipedia.org/wiki/Blood%E2%80%93brain_barrier


Circumventricular organs (CVOs) are structures in the brain that are characterized by their

extensive vasculature and lack of a normal blood brain barrier (BBB). The CVOs allow for the

linkage between the central nervous system and peripheral blood flow; additionally they are an

integral part of neuroendocrine function The lack of a blood brain barrier allows the CVOs to act

as an alternative route for peptides and hormones in the neural tissue to the peripheral blood

stream, while still protecting it from toxic substances. CVOs can be classified into (a) sensory

and (b) secretory organs. The sensory organs include the area postrema (AP), the subfornical

organ (SFO) and the vascular organ of lamina terminalis. They have the ability to sense plasma

molecules and then pass that information into other regions of the brain. Through this, they

provide direct information to the autonomic nervous system from the systemic circulation. The

secretory organs include the subcommissural organ (SCO), the posterior pituitary, the pineal

gland, the median eminence and the intermediate lobe of the pituitary gland. These organs are

responsible for secreting hormones and glycoproteins into the peripheral vascular system using

feedback from both the brain environment and external stimuli.

All of the circumventricular organs, besides the SCO,

contain extensive vasculature and fenestrated capillaries

which leads to a ‘leaky’ BBB at the site of the organs.

Furthermore, all CVOs contain neural tissue, allowing them

to play a role in the neuroendocrine system. It is highly

debated if the choroid plexus can be included as a CVO. It

has a high concentration of fenestrated capillaries, but its

lack of neural tissue and its primary role of producing

cerebrospinal fluid (CSF) usually excludes the choroid

plexus from the CVO classification.

Dielectric dispersion : - Three mechanisms are typically responsible for the dielectric dispersion

of the suspension. The gamma dispersion is a manifestation of the frequency dependence of the

permittivity of the aqueous electrolyte solution where the particles are suspended. It is mainly

determined by the polar nature of the water molecules and its characteristic frequency is in the

http://en.wikipedia.org/wiki/Blood-brain_barrier

http://en.wikipedia.org/wiki/Central_nervous_system

http://en.wikipedia.org/wiki/Peptide

http://en.wikipedia.org/wiki/Hormone

http://en.wikipedia.org/wiki/Nervous_tissue

http://en.wikipedia.org/wiki/Area_postrema

http://en.wikipedia.org/wiki/Subfornical_organ

http://en.wikipedia.org/wiki/Subfornical_organ

http://en.wikipedia.org/wiki/Vascular_organ_of_lamina_terminalis

http://en.wikipedia.org/wiki/Autonomic_Nervous_System

http://en.wikipedia.org/wiki/Systemic_circulation

http://en.wikipedia.org/wiki/Subcommissural_organ

http://en.wikipedia.org/wiki/Posterior_pituitary

http://en.wikipedia.org/wiki/Pineal_gland

http://en.wikipedia.org/wiki/Pineal_gland

http://en.wikipedia.org/wiki/Median_eminence

http://en.wikipedia.org/wiki/Pituitary_gland

http://en.wikipedia.org/wiki/Glycoprotein

http://en.wikipedia.org/wiki/Vascular_system

http://en.wikipedia.org/wiki/Fenestrated_blood_vessel

http://en.wikipedia.org/wiki/Choroid_plexus



GHz range. The delta dispersion (typically in the MHz range) is determined by the Maxwell–

Wagner–O'Konski relaxation mechanism: it occurs because of the different permittivities and

conductivities of the particle and the surrounding medium. Finally, the alpha- or Low Frequency

Dielectric Dispersion (LFDD) is a phenomenon characterized by a huge increase of the

permittivity at very low frequencies (kHz range).

Dilatant fluids: - Dilatancy is a property that exists primarily in colloidal dispersions. A colloidal

dispersion is where one substance is microscopically dispersed evenly throughout another. When

no stress is being applied, the small repulsive forces between the particles are enough to allow

them to flow past each other as a liquid. However, when a stress is applied, these small

interparticular forces are overwhelmed and they clump together,

forming hydroclusters (shown in red on diagram). The hydroclusters

make it more difficult for the particles to flow around each other, thus

increasing the viscosity. In some dilatant fluids enough stress can

cause solid-like behaviour, as essentially one large hydrocluster is

formed and none of the particles can flow around one another. When

the stress is relieved the interparticular forces cause the hydroclusters

to dissipate as the particles diffuse from the high concentrations in the

hydroclusters to the low, until an equilibrium is formed once again.

This allows the dilatant material to revert back to the fluid state.

http://dilatantfluids.weebly.com/2-structure.html

DLVO Theory - The DLVO theory is named after Derjaguin and Landau, Verwey and

Overbeek. The theory explains the aggregation of aqueous dispersions quantitatively and

describes the force between charged surfaces interacting through a liquid medium. It combines

the effects of the van der Waals attraction and the electrostatic repulsion due to the so-called

double layer of counterions. The electrostatic part of the DLVO interaction is computed in the

mean field approximation in the limit of low surface potentials - that is when the potential energy

of an elementary charge on the surface is much smaller than the thermal energy scale, . For

two spheres of radius each having a charge (expressed in units of the elementary charge)

separated by a center-to-center distance in a fluid of dielectric constant containing a

http://dilatantfluids.weebly.com/2-structure.html

http://en.wikipedia.org/wiki/Boris_Derjaguin

http://en.wikipedia.org/wiki/Lev_Landau

http://en.wikipedia.org/wiki/Evert_Verwey

http://en.wikipedia.org/w/index.php?title=Theo_Overbeek&action=edit&redlink=1

http://en.wikipedia.org/wiki/Van_der_Waals_force

http://en.wikipedia.org/wiki/Double_layer_(interfacial)

http://en.wikipedia.org/wiki/Counterion

http://en.wikipedia.org/wiki/Mean_field_approximation

http://en.wikipedia.org/wiki/Dielectric_constant


concentration of monovalent ions, the electrostatic potential takes the form of a screened-

Coulomb or Yukawa repulsion,

where is the Bjerrum length, is the Debye–Hückel screening length, which is given by

, and is the thermal energy scale at absolute temperature .

Donnan Eqilibrium: - the ionic equilibrium reached in a solution of an electrolyte whose ions

are diffusible through a semipermeable membrane but are distributed unequally on the two sides

of the membrane because of the presence of a non-diffusible colloidal ion (as a protein ion) on

one side of the membrane

Evidence-based Practice - The practice of medicine based on information gathered by a

systematic and critical review of published literature. Evidence-based practice promotes decision-

making that reflects best-available information, rather than clinical experience and perceptions of

therapeutic efficacy, which can be inaccurate. Segen's Medical Dictionary

Hado- The two ideograms which comprise this expression Hado (pronounced hadou to rhyme

with shadow) literally mean "wave" and "move". This following definition is how Dr. Emoto

himself describes the phenomenon, which led him to a series of remarkable discoveries

pertaining to the nature of water. Hado: The intrinsic vibrational pattern at the atomic level in all

matter. The smallest unit of energy. Its basis is the energy of human consciousness.

Maximum Variation Sampling – Instead of seeking representativeness through equal

probabilities, maximum variation sampling seeks it by including a wide range of extremes. The

principle is that if you deliberately try to interview a very different selection of people, their

aggregate answers can be close to the whole populations. The method sounds odd, but works well

in places where a random sample cannot be drawn. This is an extension of the statistical principle

of regression towards the mean - in other words, if a group of people is extreme in several

different ways, it will contain people who are average in other ways. So if you sought a

http://en.wikipedia.org/wiki/Yukawa_repulsion

http://en.wikipedia.org/wiki/Bjerrum_length

http://en.wikipedia.org/wiki/Debye%E2%80%93H%C3%BCckel_equation#Debye-H.C3.BCckel_theory_and_the_Debye_length


"minimum variation" sample by only trying to cover the types of people who you thought were

average, you'd be likely to miss out on a number of different groups that make up quite a high

proportion of the population. But by seeking maximum variation, average people are

automatically included.

A maximum variation sample (sometimes called a maximum diversity sample or a maximum

heterogeneity sample) is a special kind of purposive sample. Normally, a purposive sample is not

representative, and does not claim to be. However, a maximum variation sample, if carefully

drawn, can be as representative as a random sample. Despite what many people (with a little

knowledge of statistics) believe, a random sample is not necessarily the most representative,

especially when the sample size is small.

Rayleigh waves - are a type of surface acoustic wave that travel on solids. They can be produced

in materials in many ways, such as by a localized impact or by piezo-electric transduction, and

are frequently used in non-destructive testing for detecting defects. They are part of the seismic

waves that are produced on the Earth by earthquakes.

Reynolds number – It is a criterion of whether fluid flow is steady or laminar or on the average

steady with small unsteady fluctuations or turbulent. It is named for Osborne Reynolds a British

engineer and physicist in 1883, he demonstrated that the transition from laminar to turbulent flow

in a pipe depends upon the value of a mathematical quantity equal to the average velocity of flow

times the diameter of the tube times the mass density of the fluid divided by its absolute

viscosity. This mathematical quantity, a pure number without dimensions, became known as the

Reynolds number and was subsequently applied to other types of flow that are completely

enclosed or that involve a moving object completely immersed in a fluid. Whenever the Reynolds

number is less than about 2,000, flow in a pipe is generally laminar, whereas, at values greater

than 2,000, flow is usually turbulent.

Rheology (rheology is the science of deformation and flow of matter)

http://www.britannica.com/EBchecked/topic/157956/density

http://www.britannica.com/EBchecked/topic/630428/viscosity


Shear stress – A shear stress is a frictional force tangential to the direction of a flowing fluid, the

force of which is directly related to the fluid’s viscosity shear stress. In blood vessels, shear stress

acts on endothelium and is the mechanical force responsible for the acute changes in luminal

diameter.

Tanycytes are special ependymal cells found in the third ventricle of the brain, and on the floor

of the fourth ventricle and have processes extending deep into the hypothalamus. It is possible

that their function is to transfer chemical signals from the cerebrospinal fluid (CSF) to the central

nervous system (CNS). The term tanycyte comes from the Greek word tanus which means

elongated.

http://en.wikipedia.org/wiki/Ependymal_cells

http://en.wikipedia.org/wiki/Third_ventricle

http://en.wikipedia.org/wiki/Brain

http://en.wikipedia.org/wiki/Hypothalamus





Appendix 1 Hydrodynamics

The principal laws and methods of mechanics are used in solving various problems of

hydrodynamics. If necessary allowances are made for the general properties of fluids, solutions

are obtained making it possible to determine the velocity, pressure, and the shearing stress at any

given point of the space occupied by the fluid. This also makes it possible to calculate the forces

of interaction between a fluid and a solid. From the point of view of hydrodynamics the main

properties of a fluid are its high mobility, or fluidity, as evidenced by its low resistance to shear

strain and its continuity (in hydrodynamics a fluid is considered to be a continuous, homogeneous

medium). In hydrodynamics it is also assumed that a fluid has no tensile strength.

The primary equations of hydrodynamics are obtained by applying the general laws of physics to

an element of mass, isolated in the fluid, with the subsequent transition to a limit as the volume

occupied by this mass approaches zero. One of the equations, the so-called equation of

continuity, is obtained by applying the law of the conservation of mass to the element. Another

equation (or three equations, if projected on the coordinates axis) is obtained by applying the law

of momentum to an element of the fluid. According to this law, a change in the momentum of an

element of fluid must coincide in magnitude and direction with the momentum of the force

applied to this element. In hydrodynamics, the solution of general equations can be exceedingly

complex. Complete solutions are not always possible; they can be obtained only for a limited

number of special cases. Therefore, many problems must be simplified; this is done by neglecting

in the equations those members that are nonessential in determining the flow characteristics for a

given set of conditions. For instance, in many cases it is possible to describe the actually

observed flow with sufficient accuracy if the viscosity of the fluid is neglected. In this manner the

theory for an ideal liquid is obtained; this theory can be used in solving numerous problems of

hydrodynamics. In cases where the moving fluid is highly viscous (for example, thick oils),

acceleration can be neglected because the change in flow velocity is insignificant. This approach

yields another approximate solution for several problems of hydrodynamics.


The so-called Bernoulli equation is of particular importance in the hydrodynamics of an ideal

fluid. According to this equation, throughout the length of a small stream of fluid there exists the

following relationship between the pressure p, the flow velocity v (for a fluid of a density ρ), and

the height z above the reference plane: p + ½ρv2 + ρgz =constant. Here g is the acceleration due

to gravity. This is the principal equation in hydraulics.

An analysis of the equations for the motion of a viscous fluid shows that, for geometrically and

mechanically similar flows, the quantity ρvl/μ = Re must be constant. Here, l is the linear

dimension appropriate for the problem (for instance, the radius of a streamlined body, the cross-

sectional radius of a pipe), ρ is the density, v is the velocity, and μ is viscosity coefficient. The

quantity Re itself is the Reynolds number; it determines the nature of motion associated with a

viscous fluid. A laminar flow occurs at low values of Re. For instance, in pipelines laminar flow

occurs if Re = vcpd/v ≤ 2,3 where d is the diameter of the pipe and v (nu) = μ/ρ. If Re is large,

the striation in the fluid disappears and the individual masses are displaced in a random fashion;

this is so-called turbulent flow.

The principal equations of the hydrodynamics of viscous fluids turn out to be solvable only for

extreme cases—that is, either for very small Re, which (for usual dimensions) corresponds to

high viscosity, or for very large Re, which corresponds to flow conditions for low-viscosity

fluids. Problems concerning the flow of low-viscosity fluids (such as water or air) are especially

important in many technological applications. For this special case, the hydrodynamic equations

can be simplified significantly by isolating a layer of fluid that is immediately adjacent to the

surface of the body in contact with which the flow occurs (the so-called boundary layer) and for

which the viscosity cannot be neglected. Outside the boundary layer the fluid can be treated as an

ideal fluid.


Appendix 2 FLOW

Boundary-layer Flow

bau n dr l r fl ]

(fluid mechanics)

The flow of that portion of a viscous fluid which is in the neighborhood of a body in contact with

the fluid and in motion relative to the fluid.

McGraw-Hill Dictionary of Scientific & Technical Terms, 6E, Copyright © 2003 by The

McGraw-Hill Companies, Inc.

Boundary-layer Flow

That portion of a fluid flow, near a solid surface, where shear stresses are significant and the

inviscid-flow assumption may not be used. All solid surfaces interact with a viscous fluid flow

because of the no-slip condition, a physical requirement that the fluid and solid have equal

velocities at their interface. Thus a fluid flow is retarded by a fixed solid surface, and a finite,

slow-moving boundary layer is formed. A requirement for the boundary layer to be thin is that

the Reynolds number of the body be large, 103 or more. Under these conditions the flow outside

the boundary layer is essentially inviscid and plays the role of a driving mechanism for the layer.

See Reynolds number

A typical low-speed or laminar boundary layer is shown in the illustration. Such a display of the

streamwise flow vector variation near the wall is called a velocity profile. The no-slip condition

requires that u(x, 0) = 0, as shown, where u is the velocity of flow in the boundary layer. The

velocity rises monotonically with distance y from the wall, finally merging smoothly with the

outer (inviscid) stream velocity U(x). At any point in the boundary layer, the fluid shear stress

&tgr; is proportional to the local velocity gradient, assuming a newtonian fluid. The value of the

shear stress at the wall is most important, since it relates not only to the drag of the body but often

also to its heat transfer. At the edge of the boundary layer, &tgr; approaches zero asymptotically.

http://encyclopedia2.thefreedictionary.com/Reynolds+number


There is no exact spot where &tgr; = ; therefore the thickness δ of a boundary layer is usually

defined arbitrarily as the point where u = 0.99U. See Laminar flow

Typical laminar boundary-layer velocity profile

When a flow enters a duct or confined region, boundary layers immediately begin to grow on the

duct walls. An inviscid core accelerates down the duct center, but soon vanishes as the boundary

layers meet and fill the duct with viscous flow. Constrained by the duct walls into a no-growth

condition, the velocity profile settles into a fully developed shape which is independent of the

streamwise coordinate. The pressure drops linearly downstream, balanced by the mean wall-shear

stress. This is a classic and simple case of boundary-layer flow which is well documented by both

theory and experiment.

A classic incompressible boundary-layer flow is a uniform stream at velocity U, moving past a

sharp flat plate parallel to the stream. In the Reynolds number range 1 × 103 to 5 × 10

5, the flow

is laminar and orderly, with no superimposed fluctuations. The boundary-layer thickness δ grows

monotonically with x, and the shape of the velocity profile is independent of x when normalized.

The profiles are said to be similar, and they are called Blasius profiles.

The Blasius flat-plate flow results in closed-form algebraic formulas for such parameters as wall-

shear stress and boundary-layer thickness as well as for temperature and heat-transfer parameters.

http://encyclopedia2.thefreedictionary.com/Laminar+flow


These results are useful in estimating viscous effects in flow past thin bodies such as airfoils,

turbine blades, and heat-exchanger plates.

The flat plate is very distinctive in that it causes no change in outer-stream velocity U. Most body

shapes immersed in a stream flow, such as cylinders, airfoils, or ships, induce a variable outer

stream U(x) near the surface. If U increases with x, which means that pressure decreases with x,

the boundary layer is said to be in a favorable gradient and remains thin and attached to the

surface. If, however, velocity falls and pressure rises with x, the pressure gradient is unfavorable

or adverse. The low-velocity fluid near the wall is strongly decelerated by the rising pressure, and

the wall-shear stress drops off to zero. Downstream of this zero-shear or separation point, there is

backflow and the wall shear is upstream. The boundary layer thickens markedly to conserve

mass, and the outer stream separates from the body, leaving a broad, low-pressure wake

downstream. Flow separation may be predicted by boundary-layer theory, but the theory is not

able to estimate the wake properties accurately.

In most immersed-body flows, the separation and wake occur on the rear or lee side of the body,

with higher pressure and no separation on the front. The body thus experiences a large

downstream pressure force called pressure drag. This happens to all blunt bodies such as spheres

and cylinders and also to airfoils and turbomachinery blades if their angle of attack with respect

to the oncoming stream is too large. The airfoil or blade is said to be stalled, and its performance

suffers.

All laminar boundary layers, if they grow thick enough and have sufficient velocity, become

unstable. Slight disturbances, whether naturally occurring or imposed artificially, tend to grow in

amplitude, at least in a certain frequency and wavelength range. The growth begins as a selective

group of two-dimensional periodic disturbances, called Tollmien-Schlichting waves, which

become three-dimensional and nonlinear downstream and eventually burst into the strong random

fluctuations called turbulence. The critical parameter is the Reynolds number. The process of

change from laminar to turbulent flow is called transition.


The turbulent flow regime is characterized by random, three-dimensional fluctuations

superimposed upon time-mean fluid properties, including velocity, pressure, and temperature.

The fluctuations are typically 3–6% of the mean values and range in size over three orders of

magnitude, from microscale movements to large eddies of size comparable to the boundary-layer

thickness. They are readily measured by modern instruments such as hot wires and laser-Doppler

velocimeters. See Anemometer

The effect of superimposing a wide spectrum of eddies on a viscous flow is to greatly increase

mixing and transport of mass, momentum, and heat across the flow. Turbulent boundary layers

are thicker than laminar layers and have higher heat transfer and friction. The turbulent mean-

velocity profile is rather flat, with a steep gradient at the wall. The edge of the boundary layer is a

ragged, fluctuating interface which separates the nonturbulent outer flow from large turbulent

eddies in the layer. The thickness of such a layer is defined only in the time mean, and a probe

placed in the outer half of the layer would show intermittently turbulent and nonturbulent flow.

http://encyclopedia2.thefreedictionary.com/Anemometer


Appendix 3 Introduction to Complexity

COMPLICATION COMPLEXITY

Causal Interactive

Procedure Process

Dialectic Dialogue

Analysis Meaning

Definition Emergence

Repetition Synthesis

Predictability Turbulence

Programs Aims

According to a system of references Stimulate Differences

Integration Appropriation

Instruction Education

Management of the feasible Gambling on possibilities

Meta-procedure Epi-process

Probable Potential

Production Servuction (service innovation)

Analysing tasks Observing rituals

Closed Open

Control Regulation


Appendix 4 About Water Filtration in the Home

The first thing you need to know before getting a water filtration system is what type of water

you will be filtering. There are two categories; municipal treated water and "well water” or

untreated water.

For municipal treated water, the main concern is the removal of chlorine, heavy metals and other

toxins. For untreated water, the concerns are bacteria, e-coli, heavy metals and sometimes toxic

chemicals.

Filters that work great in municipally treated water are Activated Carbon filters and Ceramic

filters which contain Activated Carbon, also known as Multimedia filters. The Ceramic filter is a

combination of Activated Carbon, Ceramic and with the option of Colloidal Silver (kills

bacteria).

For well/untreated water you would want to use the following types of filters; Reverse Osmosis,

Ultra Violet Radiation Systems, Water Distillers and finally Boiling Water. Some need to be used

in conjunction with Activated Carbon.

The following are the break down for the systems mentioned, starting with Activated Carbon.

Activated Carbon

Carbon filters are able to rid water of the larger compound materials, like salt, while selectively

removing much smaller and dangerous chemicals, like chlorine and pesticides, that reverse

osmosis and distillation systems cannot remove.

Because carbon and multimedia filters utilize both chemical and physical filtration processes,

they are able to selectively remove a large number of drinking water contaminants. They can

remove the small, but dangerous pesticide and herbicide chemicals while allowing larger, trace

minerals to safely pass through the filter with the water. The retention of trace minerals in water

provides a much healthier source of drinking water. The chemical adsorption process, which


carbon and multimedia filters use, is the only filtration process that can selectively filter

unwanted materials from water.

Not all Activated Carbon filters work well. There are two kinds to my knowledge, compressed

carbon (aka carbon block) and granular carbon. The best would be a carbon block, or compressed

carbon. With the compressed carbon (carbon block), water is forced to go through all of the

carbon as it passes through. Granular Carbon filters, on the other hand, have a problem with

water making little streams through the granules, so that the water does not completely come in

contact with the carbon. They are commonly found in pitcher filters, and can be told apart from

compressed/block carbon by shaking the filter. If there is a maraca sound, it’s Granular Carbon.

If there is no sound, then it's a carbon block or compressed carbon filter. Water contact time is a

feature you also have to look at. The longer the contact time the better and more thorough the

filtration.

Some carbon filters also use colloidal silver and or KDF-55 (see below for info on KDF-55) to

prevent bacteria growth within the filter.

Ceramic Filter

Ceramic water filters rely on the small pore size of the ceramic material (usually made from

diatomaceous earth) to filter dirt, debris, and bacteria out of the water. This filtration type does

not remove chemicals. Only water and smaller contaminants will pass through. Additionally

many ceramic water filters are treated with colloidal silver to further incapacitate bacteria and

prevent the growth of mold and algae in the body of the filter (which can also grow in carbon

block filters).

Ceramic filters can be cleaned by brushing the surface with a soft brush and rinsing it out.

Some ceramic filters (the ceramic candle filters we carry) also use active carbon. Filters with

active carbon need to be replaced periodically because the carbon can only absorb so many

contaminants.


Reverse Osmosis

We used to carry Reverse Osmosis filters a long time ago, but found them to be an un-

environmental water filtration system and stopped carrying because of that. This will be

explained in a moment.

First, the Reverse Osmosis system works by forcing water through a membrane with tiny pores,

through which water can flow. Anything larger than the water molecule stays on the other side of

the membrane and goes down the drain. Unfortunately dangerous chemicals like pesticides,

herbicides, and chlorine are molecularly smaller than water. These chemicals can freely pass

through the porous membrane. For this reason, a carbon filter must be used as a complimentary

measure to provide safe drinking water from the reverse osmosis process. Such chemicals are the

major contaminants of municipally treated water, but can also be found in untreated water. In

other words, if your water source is municipally treated, reverse osmosis is not necessary (it's

actually a little overkill) as the water does not contain any bacteria, e-coli and the such. It also

does not filter chlorine.

Another downside to reverse osmosis is the removal of healthy, naturally occurring minerals in

water. The membrane does not allow natural trace minerals to pass (these are larger than water).

These minerals not only provide a good taste to water, but they also serve a vital function in the

body's system. Water, when stripped of these trace minerals, can actually be unhealthy for the

body, and becomes acidic.

As for the environmental aspect, there's always more untreated water than treated - so you end up

wasting a lot of water (literally going down the drain). It generally wastes two to four gallons of

water for every gallon of purified water it produces. So for every 5 gallons of output (filtered

water), you’re looking at 1 - 20 gallons of water down the drain.


Ultra Violet

Ultra Violet systems are actually disinfection systems. They work by shooting UV light through

the water, killing bacteria. They do not get rid of lead, particles or chemicals, so you would still

need some type of activated carbon system to work in conjunction with a UV system.

KDF-55

Kinetic Degradation Fluxion (KDF) is copper-zinc filter that uses a basic chemical process

known as redox (oxidation/reduction) to remove chlorine, lead, mercury, iron, and hydrogen

sulfide from water. It eliminates contaminants from water by using the principle of

electrochemical oxidation-reduction, known as redox potential. Redox is simply the principle of

opposites at work. Some substances are positively charged and are attracted to the negative

charge of the zinc. Others are negatively charged and attracted to the positive charge of the

copper. The process also has a mild anti-bacterial, anti-algae, and anti-fungal effect, and may

reduce the accumulation of lime scale. But it does not remove bacteria.

The KDF media is usually combined with other filter technologies to achieve better overall

results and prolong to filter life. It is never used by itself for drinking water.

Because of its ability to filter in hotter water temperatures, it is often used as a shower/bath filter

to remove chlorine and other contaminants.

Distillers

Distilled water filtration systems work by heating water to a boil in one section, then cooling and

condensing the gas to liquid form in a separate section. That leaves behind all minerals and

bacteria. Unfortunately the boiling point of most synthetic chemicals, including pesticides,

herbicides, and chlorine solutions is lower than the boiling point of water. Distillation does not

remove these harmful chemicals. The other down side to this system is it uses a lot of electricity,

making them more expensive to operate than some other systems. It also uses a lot of water.

Generally, distillation requires five gallons of tap water to generate one gallon of purified water.


It also, like reverse osmosis, strips water of natural trace elements, making the water very acidic

and potentially unhealthy.

Boiling Water

Finally, there is the old fashioned Boiling method. Boiling water is the cheapest way to kill

bacteria in your water. It is also very effective. However, boiling will only disinfect water. For

problems like lead and chemicals, boiling will actually concentrate it.

https://www.grassrootsstore.com/Countertop_Water_Filter_p/16098.htm

https://www.grassrootsstore.com/Countertop_Water_Filter_p/16098.htm


Appendix 5 MRI Scans of a paralyzed patient

Paralysis was most likely due to a build up of fluid in the vertebral canal and subsequent

unremitting compression at the level of the peripheral nerve exit due to vaso-nervorum spasm.

The patient was treated as such, and has been slowly improving since 2 weeks after first

treatment, after 3 months of no improvement and no conduction on nerve tests.

Scans all show definite signs of fluid tension.

Evident

distension

of vertebral

canal. When

I mentioned

the

distension

to the

patient, I got

the

equivalent

of an emphatic head nod.; she knew exactly what I was describing.





Appendix 6 Takotsubo cardiomyopathy

Schematic representation of takotsubo cardiomyopathy (A) compared to a normal heart (B).

The Japanese octopus traps after which this disease is named.

Left ventriculogram during systole displaying the characteristic apical ballooning with apical

motionlessness in a patient with takotsubo cardiomyopathy.

http://en.wikipedia.org/wiki/Cardiac_ventriculography

http://en.wikipedia.org/wiki/Systole_(medicine)


(A) Echocardiogram showing dilatation of the left ventricle in the acute phase. (B) Resolution of

left ventricular function on repeat echocardiogram 6 days later.

ECG showing sinus tachycardia and non-specific ST and T wave changes from a patient with

confirmed takotsubo cardiomyopathy.

Takotsubo cardiomyopathy, also known as transient apical ballooning syndrome,[1] apical

ballooning cardiomyopathy,[2] stress-induced cardiomyopathy, Gebrochenes-Herz-Syndrom, and

stress cardiomyopathy is a type of non-ischemic cardiomyopathy in which there is a sudden

temporary weakening of the muscular portion of the heart. Because this weakening can be

triggered by emotional stress, such as the death of a loved one, a break-up, or constant anxiety, it

is also known as broken-heart syndrome.[3] Stress cardiomyopathy is a well-recognized cause of

acute heart failure, lethal ventricular arrhythmias, and ventricular rupture.[4] The most defining

feature of broken heart syndrome is its transient and reversible nature, which differs from a heart

attack.[5]

The typical presentation of takotsubo cardiomyopathy is a sudden onset of congestive heart

failure associated with ECG changes mimicking a myocardial infarction of the anterior wall.

During the course of evaluation of the patient, a bulging out of the left ventricular apex with a

hypercontractile base of the left ventricle is often noted. It is the hallmark bulging out of the apex

of the heart with preserved function of the base that earned the syndrome its name "tako tsubo",

or octopus pot in Japan, where it was first described.[6]

http://en.wikipedia.org/wiki/Echocardiography

http://en.wikipedia.org/wiki/Sinus_tachycardia

http://en.wikipedia.org/wiki/ST_segment

http://en.wikipedia.org/wiki/T_wave

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-pmid18599137-1


http://en.wikipedia.org/wiki/Ischemia

http://en.wikipedia.org/wiki/Cardiomyopathy

http://en.wikipedia.org/wiki/Myocardium

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-3

http://en.wikipedia.org/wiki/Arrhythmias

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-PMID19686084-4


http://en.wikipedia.org/wiki/Congestive_heart_failure

http://en.wikipedia.org/wiki/Congestive_heart_failure

http://en.wikipedia.org/wiki/Electrocardiogram

http://en.wikipedia.org/wiki/Myocardial_infarction

http://en.wikipedia.org/wiki/Sternocostal_surface_of_heart

http://en.wikipedia.org/wiki/Japan

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Gianni-6


Stress is the main factor in takotsubo cardiomyopathy. Over 85% of cases that deal with broken

heart syndrome are set in motion by either a physically or emotionally stressful event that

prefaces the start of symptoms.[7] Examples of emotional stressors may include grief from the

death of a loved one, fear from public speaking, arguing with a spouse, relationship

disagreements, or financial problems.[7] Acute asthma, surgery, chemotherapy, and stroke are

examples of physical stressors.[7]

Takotsubo cardiomyopathy is more commonly seen in postmenopausal women.[8] Often there is a

history of a recent severe emotional or physical stress.[8]

Causes

The cause of takotsubo cardiomyopathy is not fully understood, but several mechanisms have

been proposed.

- Wraparound LAD: The left anterior descending artery (LAD) supplies the anterior wall of

the left ventricle in the majority of patients. If this artery also wraps around the apex of

the heart, it may be responsible for blood supply to the apex and the inferior wall of the

heart. Some researchers have noted a correlation between takotsubo and this type of

LAD.[9] Other researchers have shown that this anatomical variant is not common enough

to explain takotsubo cardiomyopathy.[10] This theory would also not explain documented

variants where the midventricular walls or base of the heart does not contract (akinesis).

- Transient vasospasm: Some of the original researchers of takotsubo suggested that

multiple simultaneous spasms of coronary arteries could cause enough loss of blood flow

to cause transient stunning of the myocardium.[11] Other researchers have shown that

vasospasm is much less common than initially thought.[12][13][14] It has also been noted that

when there are vasospasms, even in multiple arteries, that they do not correlate with the

areas of myocardium that are not contracting.[15]

- Microvascular dysfunction: The theory gaining the most traction is that there is

dysfunction of the coronary arteries at the level where they are no longer visible by

coronary angiography. This could include microvascular vasospasm, however it may well

also have some similarities to the diseases such as diabetes mellitus. In such disease

conditions the microvascular arteries fail to provide adequate oxygen to the myocardium.

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-circ.ahajournals.org-7



http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Azzarelli-2006-8

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Azzarelli-2006-8




http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Tsuchuhashi_K_et_al._JACC_2001-12

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Tsuchuhashi_K_et_al._JACC_2001-12

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Desmet_et_al._Heart_2003-14



- Mid-ventricular obstruction, apical stunning It has also been suggested that a mid-

ventricular wall thickening with outflow obstruction is important in the

pathophysiology.[16]

It is likely that there are multiple factors at play which could include some amount of vasospasm,

failure of the microvasculature, and an abnormal response to catecholamines (such as epinephrine

and norepinephrine, released in response to stress).[17]

Case series looking at large groups of patients report that some patients develop takotsubo

cardiomyopathy after an emotional stress, while others have a preceding clinical stressor (such as

an asthma attack or sudden illness). Roughly one third of patients have no preceding stressful

event.[18] A recent large case series from Europe found that takotsubo was slightly more frequent

during the winter season. This may be related to two different possible/suspected

pathophysiological causes: coronary spasms of microvessels, which are more prevalent in cold

weather, and viral infections – such as Parvovirus B19 – which occur more frequently during the

winter season.[1]


http://en.wikipedia.org/wiki/Epinephrine

http://en.wikipedia.org/wiki/Norepinephrine


http://en.wikipedia.org/wiki/Asthma

http://en.wikipedia.org/wiki/Takotsubo_cardiomyopathy#cite_note-Elesber_2007_448.E2.80.9352-18

http://en.wikipedia.org/wiki/Parvovirus_B19



Appendix7 Tau Pathology

McKee AC, Stein TD, Nowinski CJ, et al. The spectrum of disease in chronic traumatic

encephalopathy. Brain 2012;136:43–64

The four stages of CTE. In stage I CTE, p-tau pathology is

restricted to discrete foci in the cerebral cortex, most

commonly in the superior, dorsolateral or lateral frontal

cortices, and typically around small vessels at the depths of

sulci (black circles). In stage II CTE, there are multiple

epicentres at the depths of the cerebral sulci and localized

spread of neurofibrillary pathology from these epicentres to

the superficial layers of adjacent cortex. The medial

temporal lobe is spared neurofibrillary p-tau pathology in

stage II CTE. In stage III, p-tau pathology is widespread;

the frontal, insular, temporal and parietal cortices show

neurofibrillary degeneration with greatest severity in the

frontal and temporal lobe, concentrated at the depths of the

sulci. Also in stage III CTE, the amygdala, hippocampus

and entorhinal cortex show neurofibrillary pathology. In

stage IV CTE, there is severe p-tau pathology affecting

most regions of the cerebral cortex and the medial temporal

lobe, sparing calcarine cortex in all but the most severe

cases. All images, CP-13 immunostained 50-µm tissue

sections.


Appendix 8 Chlorine and your shower

"Taking long hot showers is a health risk, according to research presented last week in Anaheim,

California, at a meeting of the American Chemical Society. Showers-and to a lesser extent baths-

lead to a greater exposure to toxic chemicals contained in water supplies than does drinking the

water.

The chemicals evaporate out of the water and are inhaled. They can also spread through the house

and be inhaled by others. House holders can receive 6 to 100 times more of the chemical by

breathing the air around showers and bath than they would by drinking the water."

NEW SCIENTIST 18 September 1986 lan Anderson

"Studies indicate the suspect chemicals can also be inhaled and absorbed through the skin during

showering and bathing."

``Ironically, even the Chlorine widely used to disinfect water produces Carcinogenic traces."

"Though 7 out of 10 Americans drink chlorinated water, its safety over the long term is

uncertain."

"Drinking chlorinated water may as much as double the risk of the Bladder Cancer, which strikes

40,000 people a year."

U.S. NEWS & WORLD REPORT - July 29 1991 Is Your Water Safe-The Dangerous State of

Your Water

"On one hand, chlorination has freed civilization from the constant dangers of waterborne

epidemics. On the other hand in the mid-70s scientists discovered that chlorination could create

carcinogens in water."

"80% of the population drinks chlorinated water."


"There was a higher incidence of cancer of the esophagus, rectum, breast, and larynx and of

Hodgkins Disease among those drinking chlorinated surface waters."

"Volatile organics can evaporate from water in a shower or bath."

"Conservative calculations indicate that inhalation exposures can be as significant as exposure

from drinking the water, that is, one can be exposed to just as much by inhalation during a

shower as by drinking 2 liters of water a day."

"People who shower frequently could be exposed through ingestion, inhalation and/or dermal

absorption. "

IS YOUR WATER SAFE TO DRINK? Consumer Reports Books

"Skin absorption of contaminant has been underestimated and ingestion may not constitute the

sole or even primary route of exposure."

AMERICAN JOURNAL OF PUBLIC HEALTH, Dr. Halina Brown

"Showering is suspected as the primary cause of elevated levels of chloroform in nearly every

home because of the chlorine in the water."

ENVIRONMENTAL PROTECTION AGENCY Dr. Lance Wallace

"A Professor of Water Chemistry at the University of Pittsburgh claims that exposure to

vaporized chemicals in the water supplies through showering, bathing, and inhalation is 100

times greater than through drinking the water."


"As chlorine is added to kill pathogenic microorganisms, the highly reactive chlorine combines

with fatty acids and carbon fragments to form a variety of toxic compounds, which comprise

about 30% of the chlorination by-products."

"During the mid-1970s monitoring efforts began to identify widespread toxic contamination of

the nation's drinking water supplies, epidemiological studies began to suggest a link between

ingestion of toxic chemicals in the water and elevated cancer mortality risks.

Since those studies were completed a variety of additional studies have strengthened the

statistical connection between consumption of toxins in water and elevated cancer risks.

Moreover, this basic concern has been heightened by other research discoveries.

THE NADER REPORT - TROUBLED WATERS ON TAP Center For Study of Responsive Law

"The National Academy of Sciences estimate that 200 to 1000 people die in the United States

each year from cancers caused by ingesting the contaminants in water. The major health threat

posed by these pollutants is far more likely to be from their inhalation as air pollutants. The

reason that emissions are high is that because water droplets dispersed by the shower head have a

larger surface-to-value ratio than water streaming into the bath."

SCIENCE NEWS: VOL. 130 Janet Raloff

"Chlorine gas was despicably used during WWI. When the war was over, the use of chlorine was

diverted to poisoning germs in our drinking water. All water supplies throughout the country

were chlorinated. The combination of chlorine (when in drinking water) and animal fats results in

atherosclerosis, heart attacks, and death."

WATER CAN UNDERMINE YOUR HEALTH


"The cause of atherosclerosis and resulting heart attacks and strokes is none other than the

ubiquitous chlorine in our drinking water."

"Chlorine is the greatest crippler and killer of modern times. While it prevented epidemics o one

disease, it was creating another. Two decades ago, after the start of chlorinating our drinking

water in 1904. The present epidemic of heart trouble, cancer and senility began."

SAGINAW HOSPITAL Dr. J.M. Price, MD.

"Cancer risk among people drinking chlorinated water is 93% higher than among those whose

water does not contain chlorine."

U.S. COUNCIL OF ENVIRONMENTAL QUALITY

"Known carcinogens are found in drinking water as a direct consequence of the practice of

chlorination. A long established public health practice for the disinfection of drinking water."

MUNICIPAL ENVIRONMENTAL RESEARCH LABORATORY Francis T. Mayo, Director

"Chlorine is used almost universally in the treatment of public drinking water because of its toxic

effect on harmful bacteria and other waterborne, disease-causing organisms. But there is a

growing body of scientific evidence that shows that chlorine in drinking water may actually pose

greater long term dangers than those for which it was used to eliminate.

These effects of chlorine may result from either ingestion or absorption through the skin.

Scientific studies have linked chlorine and chlorination by-products to cancer of the bladder,

liver, stomach, rectum, and colon, as well as heart disease, atherosclerosis (hardening of the

arteries), anemia, high blood pressure, and allergic reactions. There is also evidence that shows

that chlorine can destroy protein in our body and cause adverse effects on skin and hair.


Appendix 9 Balneotherapy

Balneotherapy is a broad classification for various types of health treatments that make use of

water. The most common forms of balneotherapy involve the immersion of a patient into water.

Treatments may take place in bathtubs, pools, or natural bodies of water.

The essential concept of balneotherapy has been around for thousands of years. Early Greek and

Roman medical treatments often involved the use of mineral-rich hot springs to assist with

various types of ailments. This simple water therapy was understood to help with conditions

ranging from nervous conditions to easing the pain of arthritis.

A baleneotherapist may choose to utilize different types of water therapy in order to treat a

particular medical condition. Hot springs often are used to help with circulation issues caused by

diabetes or other illnesses that impact the flow of blood to the extremities. Mineral baths may be

utilized as part of the treatment for various types of skin problems. Even sea water may be

employed when the focus is on relieving stress or calming jangled nerves.

Both hot and cold water may be used in various types of balneotherapy treatments. Some of the

hydrotherapy solutions involve the use of moving water as part of the process of treatment.

Generally speaking, warmer water is used when there is a need to soothe or relax. Colder water is

utilized when there is a need to stimulate the body and mind.

Balneotherapy may include the use of water that has a high content of essential minerals, such as

calcium and magnesium. The relief that many patients experience with treatments in natural

springs is thought to come from the exposure to and absorption of needed nutrients through the

skin during a treatment. At the same time, it is possible to add natural element such as chamomile

or mint leaves to a hot bath and achieve some mental and physical benefits.

Over the centuries, balneotherapy has been used in the treatment of all sorts of conditions,

including leprosy, heart problems and mental disorders. While medical evidence to support all the

various uses of balneotherapy is somewhat limited, there is some proof that the use of

http://www.wisegeek.com/what-are-hot-springs.htm

http://www.wisegeek.com/what-is-hydrotherapy.htm

http://www.wisegeek.com/what-is-leprosy.htm


hydrotherapy can be relaxing and help with stimulating the body’s immune system. Research in

the effective applications of balneotherapy continues among western medicine and various

homeopathic disciplines as well.

http://www.wisegeek.com/what-is-balneotherapy.htm

Health Benefits of Balneotherapy

Balneotherapy is thought to promote healing by increasing circulation, encouraging detox and

easing stress. In addition, the minerals found in hot springs (such as sulfur and magnesium) are

said to fight off illness by nourishing the organs and stimulating the immune system. Although

few studies have tested these health claims, some research suggests that balneotherapy may help

with certain conditions. Here's a look at several key study findings.

1) Arthritis

Mineral baths may be somewhat helpful for people with osteoarthritis, according to a 2008

review published in the Journal of Rheumatology. Analyzing seven trials (with a total of 498

patients), investigators found evidence that balneotherapy was more effective than no treatment at

all. However, the review's authors warn that this evidence is weak, due to the poor quality of the

trials.

Similarly, a 2003 review from the Cochrane Database of Systematic Reviews looked at six

trials (with a total of 355 participants) and found some evidence that balneotherapy can help treat

rheumatoid arthritis.

Due to major flaws in the studies, however, the review's authors caution that this is evidence is

inconclusive.

2) Fibromyalgia

Balneotherapy may help treat fibromyalgia, according to a small study published in

Rheumatology International in 2002. For the study, 42 fibromyalgia patients were assigned to

either a control group or three weeks of 20-minute bathing sessions (administered once a day,

five times a week). Study results showed that those treated with balneotherapy showed significant

http://www.wisegeek.com/what-is-balneotherapy.htm

http://altmedicine.about.com/cs/dietarytherapy/a/Detox_Diet_Plan.htm

http://altmedicine.about.com/od/aznaturalremedyindex/a/stress_management.htm

http://altmedicine.about.com/od/healthconditionsdisease/a/immune_boost.htm

http://altmedicine.about.com/od/healthconditionsdisease/a/osteoarthritis.htm

http://altmedicine.about.com/od/arthritis/a/rheumatoid.htm

http://altmedicine.about.com/cs/conditionsetoh/a/Fibromyalgia.htm


improvements in some fibromyalgia symptoms and in depression (a common problem among

people with fibromyalgia).

3) Low Back Pain

In a 2005 study from Research in Complementary and Natural Classical Medicine ,

scientists found that bathing in sulphurous mineral water may help alleviate low back pain.

Compared to 30 back-pain patients who underwent a tap-water-based hydrotherapy treatment, the

30 patients in the balneotherapy group showed greater improvements in muscle spasms,

tenderness, and flexibility.

Using Balneotherapy for Health

If you're interested in using balneotherapy to prevent or manage a specific health problem, make

sure to consult your physician before beginning treatment. Self-treating and avoiding or delaying

standard care can have serious consequences.

Sources

Balogh Z, Ordögh J, Gász A, Német L, Bender T. "Effectiveness of balneotherapy in chronic low back pain -- a randomized single-blind

controlled follow-up study." Forsch Komplementarmed Klass Naturheilkd. 2005 Aug;12(4):196-201.

Evcik D, Kizilay B, Gökçen E. "The effects of balneotherapy on fibromyalgia patients." Rheumatol Int. 2002 Jun;22(2):56-9.

Verhagen AP, Bierma-Zeinstra SM, Cardoso JR, de Bie RA, Boers M, de Vet HC. "Balneotherapy for rheumatoid arthritis." Cochrane Database

Syst Rev. 2003;(4):CD000518.

Verhagen A, Bierma-Zeinstra S, Lambeck J, Cardoso JR, de Bie R, Boers M, de Vet HC. "Balneotherapy for osteoarthritis. A cochrane review." J

Rheumatol. 2008 Jun;35(6):1118-23.

http://altmedicine.about.com/od/healthconditionsatod/a/Depression1.htm

http://altmedicine.about.com/od/chronicpain/a/back_pain.htm


Appendix 10 Emoto Water Crystals



Appendix 11 The VAS and Auricular Medicine

Paul Nogier, a medical doctor who taught neurology at the medical school in Lyon, France,

discovered in the late 195 ’s that the ear holds all of the acupuncture points of the body,

replicating as a microsystem every part of the body. Nogier and his students systematically

mapped these points, opening up the field of auricular acupuncture, also called auriculotherapy.

Later, in 1966 he made the further discovery of the Vascular Autonomic Signal (VAS) by

noticing a pulse change when he touched the skin of a patient. The VAS is one physiological

response of the neurovascular system of the body to information being brought into its energy

field, a response that creates a "signal" that can be manually felt as a pulse change on the wall of

the radial artery. This discovery of the VAS brought an energetic diagnostic tool to the world that

became the cornerstone of auricular medicine. The potential of this discovery has yet to be fully

realized.

Although the term "signal" as in the "Vascular Autonomic Signal" is the common term that was

adopted to refer to this phenomenon, current practitioners see the term "response" as being more

accurate. "Response is the consequence of a question"; says Yves Rouxeville, a Nogier student.

The VAS represents the body’s specific reaction, or response, to the question posed by the

introduction of a stimulation into the energy field.

Biophoton research has found that when a body system is stressed and unhealthy, the

electromagnetic field extends further out than when a body is free of stress and healthy. It is

theorized that this extension of the field is due to an increase in disorderliness and quantity of

photons, or electromagnetic signals, being emitted by the body when under stress. Thus any

disturbed structure or function of the body can result in a stressed electromagnetic field, which is

reflected by one or several acupuncture points on the microsystem of the ear. When a substance

or colour (in the form of a "filter") has the same electromagnetic signature or harmonic of the

signal of the stressed acupuncture point, the two will resonate with each other. The minute

irritation caused by this resonance is reflected by a change in the tone of the arterial wall – the

VAS.


Toward an Integral Energy Medicine Model For Understanding The Vascular Autonomic

Signal, Holos University Graduate Seminary, In partial Fulfillment of the Requirements

for the Th. D. Degree in Spiritual Healing / Energy Medicine, Muriel Agnes, February

2002.

NOGIER PULSE REFLEX

The Function of the Cardiovascular System that BOTH Western & Eastern Medicine Had Never

Noticed Before

By Dr. Donald Liebell

Some say it's like being

hooked up to a polygraph, or

lie detector for their health.

We’re “asking the body

questions” by adding and

subtracting electromagnetic

frequency stimuli. The

Nogier pulse reflex is giving

the answers. It is a

phenomenon that can be deftly utilized to determine the possible causes of health problems, and

predict likely effective treatments... often when conventional medical testing comes up empty.

During the late 1960s neurologist, acupuncturist, and homeopathic physician, Paul Nogier,

M.D., noticed that he consistently felt a very subtle, but consistent change in arterial muscular

contraction when he approached acupuncture points on the ear. His research revealed that this

was a normal, expected, and predictable reflex of the cardiovascular system. Others throughout

history had known that changes could be manually felt in the pulse with various stresses, but not

with the intent and precision of Nogier—in the context of auricular therapy (ear acupuncture).

http://earsecret.com/Dr.html

http://earsecret.com/Dr.html

http://earsecret.com/3-Phase_Ear_Acupuncture_2.html


Pulses had long been utilized in evaluation in traditional Chinese medicine—but for completely

different purposes. Western medicine has a rich history of monitoring cardiovascular health

through monitor the pulse for heart rate. However, with the Nogier pulse reflex (also called the

Vascular Autonomic Signal), we are not monitoring the pulse rate, but rather a momentary

change in how firm or strong it feels.

The intentional triggering of this pulse reflex for medical diagnostic purposes had never been

conceived. Dr. Nogier discovered that physical stimulation of the skin could induce this

extremely subtle “shuddering” of the arteries throughout the body—best felt at the wrist (the

radial pulse). More fascinating were his findings from experiments with color light filters, sound,

magnetic fields, and other variables. Nogier developed a method of challenging the patient’s

body with various stimuli—using the pulse reflex as a means of providing information that might

not be found by other medical means. During this auricular medicine bio-energetic exam, our

intention is to measure how far off of the body the human electric field is projected, in response

to various test stimuli. The Nogier pulse reflex makes this possible.

The true tools of the exam are the examiners fingers (to feel the pulse of the patient), and a

special color light filter that will trigger the reflex the moment it contacts the outer margin of the

patient’s living electric field.

Throughout the exam, the reflex is caused to naturally “fire” in response to temporary test

samples. It is a very delicate procedure; it requires very well-trained and experienced hands, and

a fine sense of touch to consistently and reliably detect the Nogier reflex. It is done by gliding a

specialized Kodak-Wratten light filter towards your ear. When the light filter reaches the border

of your body’s electric field, it triggers the expected Nogier pulse reflex, which results from

muscle contraction within arteries.

The Nogier pulse reflex is also known as the Vascular Autonomic Signal. It is a subtle nuance—

a tiny bulging sensation (caused by reflected waves in the arteries) is felt by the doctor while

monitoring the pulse at the wrist. This normal reflex of your cardiovascular system goes on

http://earsecret.com/Light___Color_Filters.html

http://earsecret.com/Bio-Energetic_Testing.html



silently in your body regularly, in response to various stimuli. The phenomenon was first

observed unintentionally, during an artery operation around 1945 by the famous French surgeon,

Rene Leriche (1879-1955). But it wasn’t until 1966 that Dr. Paul Nogier found a use for it in

clinical practice. He discovered that the reflex could be intentionally triggered using the light

filter technique, as well as probing over acupuncture points on the ear. Under healthy conditions,

it should trigger around one-half-inch away from the ear—the normal healthy distance of the

human electrical field.

Use of the Nogier Pulse Reflex in Bio-Energetic Resonance Testing

Since all substances have a specific frequency, we can briefly stress the body with a test

sample to see if a resonance or a vibrational match exists. In other words, if an area of the body

is troubled, we can stress it briefly with more of the offending substance—and the human electric

field will temporarily expand farther away from the ear. Any toxic substance held in your hand

will cause your electric field to expand too.

Here’s an example of how the Nogier pulse reflex (vascular autonomic signal) is used in

clinical practice with auricular medicine techniques:

If we suspect your body might be storing toxic metals, such as aluminum, we briefly stress

your body with a laboratory prepared, diluted sample of it, by adding it to the test plate

(connected to the patient by conduction wire and metal bar)—to see if your body has resonance

with it. It is expected that if aluminum is excess in the body that we would observe your pulse

reflex to be triggered at a much farther distance off of your ear than with nothing on the plate. If

we remove the aluminum sample, the pulse reflex triggers at its original distance. While this is

not clinical diagnosis of aluminum toxicity; it does give us an energetic suggestion of a

subclinical problem.

http://earsecret.com/Physics_of_Resonance.html


Subsequently, we want to test samples of homeopathic supplements to see which will bring the

electric field closest to normal. This resonance testing process is repeated for dozens of diluted,

laboratory prepared, inactive samples of different substances, including: organs and tissues,

bacteria, viruses, fungi, and other parasites, toxins, heavy metals, scar tissue, and other

substances.

At this point in time, the American medical establishment generally does not acknowledge

energetic findings, with the exception of those of EKG, MRI, and a few others. Under no

circumstances do I represent any observation or comments during an evaluation as evidence of

any medical condition. We are not performing auricular medicine bio-energetic testing to give

your symptoms or condition a name.

It cannot be stressed enough that the purpose of auricular medicine is to determine whole-body,

wellness-based treatment—it is NOT conventional medical diagnosis. Nor is it direct treatment

of ANY specific disease or illness. The subsequently recommended complex homeopathic

supplements and ear acupuncture are provided as health and wellness supports for regulation and

boosting of immune system, as well as for cellular detoxification, and natural regeneration and

repair. Both homeopathy and auricular therapy ear acupuncture are FDA cleared, internationally

recognized and accepted wellness methods. I am licensed to provide acupuncture by the Virginia

Board of Medicine.

Armed with the Nogier pulse reflex, the doctor can “ask” the nervous system questions… and

get answers that cannot be obtained through physical tests. By combining use of this natural

pulse reflex with light filters, resonance substance samples, and auricular therapy ear acupuncture

technique, a remarkable amount of energetic information can be deduced from the body.

Doctors listen to the heartbeat through a stethoscope. Blood pressure, heart rate, and other

functions can be measured through various technologies. At this point in time, interest in the

application of the Nogier reflex is still in its infancy, even though Dr. Paul Nogier introduced it

decades ago. “Mainstream” American medicine has sadly ignored his discovery. Dr Nogier

(1908-1996) was decorated for his contributions to medicine by the French government, and it is

http://earsecret.com/Homeopathic_Medicine.html

http://earsecret.com/Bio-Energetic_Testing.html

http://earsecret.com/Homeopathic_Medicine.html





primarily European doctors, who recognize the remarkable value of his pulse reflex in health

care. It has been a thrill for me to see how much my patients appreciate its use towards their

recovery from pain and illness.

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