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STEOPATHY IN THE
John M. McPartland, DO, MSc,
and Evelyn Skinner, DO, BA
“The Tao that can be completely explained is not the Tao itself.”—
Lao Tzu, Tao Te Ching
This chapter concerns the philosophy underlying the Biody-
namic model of osteopathy in the cranial ﬁeld (BOCF). To do
this we employ a Hegelian dialectic, a weave of BOCF principles
with BOCF science, presented within an historical context.
We will compare biomechanical OCF with Biodynamic
OCF, or “left-brained versus right-brained cranial” as Fred
Mitchell likes to quip. No treatment methods will be described
here. Note that certain words in this article will be capitalized,
indicating the usage of a deﬁned BOCF meaning, not a standard
BOCF’s legacy extends back to Hippocrates, as reﬂected in
the Hippocratic Oath’s axiom “do no harm,” and its concern for
our triune (body-mind-spirit) integrity. Threads of Paracelcus-
style empiricism and Avicennian experimentalism colour the
BOCF tapestry. The foundation of BOCF, however, is ﬁrmly
grounded in the philosophy and practice of three osteopathic
teacher-physicians, evolving from three lifetimes spent in gen-
eral medical practice, working alongside the self-balancing, self-
healing principles present in their patients.
The ﬁrst of these teacher-physicians is Andrew Taylor Still
(1828-1917), who founded osteopathy in 1874. Dr. Still sought
“the Health” in his patients, which was always present no matter
how sick his patients presented. This concept was fundamental
to Still’s hands-on approach to care. “I love my patients,” he
declared, “I see God in their faces and their form” ( Still 1908).
The physician’s task, Still always reminded his students, was to
remove with gentleness all perceived mechanical obstructions to
the free-ﬂowing rivers of life (blood, lymph, and cerebro-spinal
ﬂuid). Nature would then do the rest. Still formulated innova-
tive concepts regarding the cranium, the cranial nerves, and he
famously proclaimed, “the cerebrospinal ﬂuid [CSF] is the high-
est known element that is contained in the human body” ( Still
1899). His treatment techniques included gentle pressure on
cranial bones, for example in the treatment of pterygium ( Still
The second of these teacher-physicians is William Garner
Sutherland (1873-1954), who founded Osteopathy in the Cra-
nial Field (OCF). Dr. Sutherland was a student of Still and
became imbued with Still’s thinking, methods, and practice.
Sutherland formulated his ﬁrst cranial hypothesis as a student in
1899 while examining a temporal bone from a disarticulated
skull. The thought struck him that its edges were bevelled like
the gills of a ﬁsh, as if part of a respiratory system. Sutherland’s
1899 revelation initiated a life-long evolution of thought, de-
scribed in subsequent sections of this chapter.
The third teacher-physician is James S. Jealous (1943-) whose
Biodynamic Model of OCF (BOCF) has attracted great interest
and controversy within the profession. Jealous adapted the term
Biodynamic from his study of the German embryologist Erich
Blechschmidt, and not from the Swiss philosopher Rudolf
Steiner, although Steiner’s Biodynamic concepts resonate with
BOCF principles. For over 30 years Dr. Jealous has compiled
oral histories from Sutherland’s students, and he continues to
research Sutherland’s writings (both published and unpub-
lished). This “work with the elders” enabled Jealous to compile
an authoritative chronology of Sutherland’s journey. Thus
BOCF dedicates itself to the perceptual odyssey where Suther-
land left off at the end of his life.
METAPHOR AND ARCHETYPE: THE KEEPERS OF THE
Still (1902) wrote, “. . .that life and matter can be united, and
that the union cannot continue with any hindrance to free and
absolute motion.” Still’s concepts, from the beginning, were
already beyond the capabilities of double-blind trials. What Still
saw and understood, and Sutherland came to reﬁne in his later
writings, was the universal principle that the natural world is
constantly changing, and what is ﬁxed (or without motion) be-
comes out of balance with its environment. Still considered
osteopathy a science, but when Still’s osteopathy extended be-
yond known science and rational explanation, he imparted his
lessons by using metaphorical language. A metaphor uses famil-
iar information to describe an unfamiliar idea. Metaphor pro-
vides a verbal bridge to gap the space between the speaker’s
intention and the listener’s interpretation ( Artaud 1938). This
transformational space, metaphorically speaking, characterizes
the learning space between teacher and student, the theatre
space between actor and audience, and the healing space be-
tween the practitioner and patient, where at a certain moment
during an exchange something greater than the sum of the parts
Metaphors, despite being inherently nonrational, have long
provided heuristic tools for approaching scientiﬁc problems
( Chew & Laubichler 2003). Western culture, however, has difﬁ-
culty grasping nonrational thought. The nonrational aspects of
osteopathy (and other alternative medical systems) are the most
1 School of Osteopathy, UNITEC, Auckland, New Zealand;
2 Department of Family Practice, College of Medicine, University of
Vermont, Burlington, Vermont; and
3 The Twig Centre, Wellington, New Zealand
Adapted and reprinted with permission from Cranial Osteopathy by Tor-
sten Liem and Cranial Manipulation by Leon Chaitow, both published
by Elsevier Health Sciences, 2004.
#Corresponding author. Address:
UNITEC, Health and Environmental Science, Private Bag 92025, Auck-
land 1650, New Zealand.
21EXPLORE January 2005, Vol. 1, No. 1
difﬁcult lessons to impart and the most difﬁcult traditions to
maintain. The man-as-triune truths that lay behind Still’s oste-
opathy became the victims of medical reductionism, casualties
of our Western way of emphasising the intellectual and eschew-
ing the intuitive and instinctual. Reductionism limits our view of
reality and our faculty of awareness (sense of consciousness).
Alternative forms of consciousness, as expressed through
dreams, poetry, music, painting, or as found in cultures outside
the West, such as meditation or trance states, have remained
undeveloped in our society. Limiting our knowledge to what can
be proven in a reductionist experiment has consistently suc-
ceeded in excluding the human spirit from the Western medical
This lack of spirit has been a concern of BOCF practitioners,
who gained insight and inspiration from Laurens van der Post
(1962), “Man’s awareness since the Reformation has been so
narrowed that it has become almost entirely a rational process,
an intellectual process associated with the outside, the so-called
physical, objective world. The invisible realities are no longer
real. This narrowed awareness rejects all sorts of things that make
up the totality of the human spirit: intuition, instincts and feel-
ings, all the things to which natural man had access.” Van der
Post’s anthropological concepts have played an important role
in our understanding of health and disease in society.
Still no doubt acquired the skill of communicating symboli-
cally-rich language from his father, a Methodist Minister. Suth-
erland, like Still, was a practiced wordsmith, having worked as a
newspaper editor before training as an osteopath. Still’s and
Sutherland’s language reﬂected the intimacy of their connection
with the natural world. Still matured among the Shawnee and
other Native American peoples–primal cultures, in anthropolog-
ical terms. “In indigenous, oral cultures, nature itself is articulate;
it speaks. . . There is no element of the landscape that is deﬁni-
tively void of expressive resonance and power. . .” ( Abram 1996).
Abram quotes a Native American healer, whose words resonate
with the writing of Dr. Still, “In the act of perception, I enter into
a sympathetic relation with the perceived, which is possible only
because neither my body nor the sensible exists outside the ﬂux
of time, and so each has its own dynamism, its own pulsation
and style. Perception, in this sense, is an attunement or synchro-
nization between my own rhythms and the rhythms of the
things themselves, their own tones and textures.”
Still’s landscape was peopled by individuals who saw things
from a totally different cultural perspective. Highwater (1981)
wrote, “Though the dominant societies usually presume that
their vision represents the sole truth about the world, each soci-
ety (and often individuals within the same society) sees reality
uniquely.” Still’s and Sutherland’s unique cultural perspectives
have been revived by BOCF practitioners. BOCF initially
evolved in New England, a land imbued with the spirit of Ralph
Emerson and Henry Thoreau. These 19th century New England
philosophers believed that the study of Nature, or being out-of-
doors in the natural world, offered a cleansing of the mind and
spirit, and enhanced the journey of self-discovery.
At the time Sutherland (1939) ﬁrst published his insights,
osteopathy was undergoing a period of reductionism. Most prac-
titioners focused on the mechanistic aspects of osteopathic prin-
ciples and practices. Sutherland’s OCF represented a Renais-
sance of Still’s osteopathy. But by the time of Sutherland’s death
in 1954, the OCF Renaissance itself entered a Reformational
period, a reclaiming of the rational. Reformational OCF and its
basic texts ( Magoun 1976, Upledger & Vredevoogd 1983) have
been embraced by many osteopaths as well as massage thera-
pists, physical therapists, and chiropractors. But Sutherland’s
original Renaissance has carried on, under the aegis of his osteo-
pathic students including Paul Kimberly, Anne Wales, Ruby
Day, Rollin Becker, and Robert Fulford ( Cardy 2004).
As OCF has led to BOCF, the use of metaphor has led to the
use of archetype. Whereas a metaphor is a ﬁgure of speech used
to suggest a resemblance, an archetype is a term used to describe
a universal symbol that evokes deep and sometimes unconscious
responses in a reader or listener. Archetypes symbolically em-
body basic human experiences and their meaning is instinctually
and intuitively understood. Jealous’s concept of “the embryo” as
ever present in the living organism is a key BOCF archetype. When
studying the writings of the embryologist Blechschmidt (de-
scribed below), Jealous was impressed by Blechschmidt’s conclu-
sion that embryonic function (ﬂuid motion) creates form and
precedes structure. Jealous (2001) intuited from Blechschmidt’s
reports that the embryologist must have witnessed the organisa-
tional forces of primary respiration at work, without the palpa-
tory conﬁrmation, given the reverence with which Blechschmidt
& Gasser (1978) wrote, “The originality of embryonic human
beings is discernible in many ways; for example, the early human
conceptus is master of the whole geometry that it applies to
itself. It is never mistaken about any angular sum, and it is never
deceived in any surface to volume ration. It never sets an inter-
secting point on the wrong site and is master of every physical as
well as chemical reaction.”
The embryo, as an archetype of perfect form, serves as a blue-
print for our body’s ability to heal itself. The formative, resorba-
tive, and regenerative ﬂuid forces that organize embryological
development are present throughout our life span, ready for our
cooperation in harnessing their therapeutic potency. In other
words, the forces of embryogenesis become the forces of healing
Among BOCF practitioners, every event within the thera-
peutic arena has a name. Nothing is referred to vaguely in
terms of “energy.” The importance of naming is shared by
primal cultures worldwide, notably the Bushmen of the Kala-
hari ( van der Post 1961). According to the Bushman, an indi-
vidual’s separation from that part of themselves that is con-
nected to “everything else” leads to fear and a sense of
aloneness, and this facilitates the disease process. Because
treatment using the BOCF connects the patient to nature, the
patient receives an immediate experience of “not-aloneness”
or “belonging” in a deep way. Patients gain a physical sense of
“community,” possibly for the ﬁrst time in their life. As Wen-
dell Berry (1996) emphasized, “The community is the small-
est unit of health.”
In the next three sections of this article, we review OCF’s
and BOCF’s evolution of thought, evolution of perceptual
skills, and evolution of treatment approaches–from the Bones
to the Dura to the CSF to the Fluid Body. See Figure 1 for a
22 EXPLORE January 2005, Vol. 1, No. 1 Biodynamic Model of Osteopathy
EVOLUTION OF THOUGHT
From his student days until the late 1920s, Sutherland concen-
trated on cranial bones, their sutures, and foraminae. Sutherland
proposed that cranial sutures remain mobile throughout a per-
son’s life. His hands-on insights predicted what is now known
through histological studies–that most cranial sutures never
completely ossify ( Retzlaff & Mitchell 1987). Living sutures con-
tain connective tissue, blood vessels, and nerves. They maintain
articular function and serve as crossroads of metabolic motion
and somatic information. Sutherland’s deductive observations
were conﬁrmed by research completed by his osteopathic con-
temporary, Charlotte Weaver. She conducted fetal dissections
that led her to regard the bones of the cranium as modiﬁed
vertebrae ( Weaver 1936a, 1936b). The sphenobasilar symphysis
is embryologically homologous to an intervertebral disc, it is
plastic and capable of motion ( Weaver 1938). Thus Weaver
proved true the insights Goethe had in 1790, that the bones of
the cranium are metamorphized vertebrae ( Rohen 2002).
In the early 1930s Sutherland shifted his emphasis to the dura
and its bilaminar infoldings that form the falx and the tento-
rium, collectively known as the reciprocal tension membrane,
which balances motion within the skull. Sutherland accessed the
dura by gently gripping the cranium. The external periosteum is
contiguous with the internal dura. Sutherland visualized one
continuous web of connective tissue, from the cranium down to
the sacrum, which he characterized as the tadpole-shaped “core
In the middle 1930s Sutherland shifted his focus to the ﬂuctua-
tion of CSF, driven by what he termed the Primary Respiratory
Mechanism (PRM). He postulated that the PRM consists of ﬁve
phenomenae ( Magoun 1976):
●the inherent motility of the brain and the spinal cord;
●ﬂuctuation of the CSF;
●motility of the intracranial and intraspinal membranes;
●articular mobility of the bones of the cranium; and
●involuntary mobility of the sacrum between the ilia.
Sutherland described CSF circulating down and around the
spinal chord in a rhythmically pulsatile and spiral fashion. Sci-
ence has again caught up with his hands-on insights, thanks to
advances in radionuclide magnetic resonance imaging ( Greitz et
al 1997). Many practitioners call the pulsation the cranial rhyth-
mic impulse (CRI), a term coined by Rachel and John Woods in
1961. Clinical studies report a palpable CRI rate of 6-12 cycles/
min, independent of cardiac or diaphragmatic rhythms ( Ma-
The CRI phenomenon is poorly understood and its origin
remains unknown (acupuncturists face a similar situation when
asked to describe chi). Many researchers have made hypotheses
regarding its source. Initially, Sutherland (1939) proposed that
pulsations arise from rhythmical motions of the brain, causing
dilatation and contraction of cerebral ventricles, generating a
pulse wave of CSF. Magoun (1976) elaborated on this proposal
and also posed an alternative hypothesis–that the choroid plexus
produces CSF in rhythmic cycles, and this oscillation generates
brain motility. Upledger & Vredevoogd (1983) reﬁned the cho-
roid plexus hypothesis, calling it the “pressurestat model.” Mc-
Partland & Mein (1997) called the CRI a palpable harmonic fre-
quency, a summation of several pulsations such as CSF
oscillations, the cardiac pulse, diaphragmatic respiration,
Traube-Hering modulations, rhythmically contractile lymphatic
vessels, pulsating glial cells, and other polyrhythms. This “en-
trainment hypothesis” has been put forward independently (eg,
Milne 1998) and recently supported by experimental data ( Nel-
son et al 2001). Many of these biological oscillators are lesioned
by imbalanced autonomic tone ( Schleip 2002) making the CRI
variable and ephemeral. Thus from a BOCF perspective the CRI
is a lesion phenomenon.
Many osteopaths today work within the CRI models pro-
posed by Magoun or Upledger, but Sutherland moved on. In
the ﬁnal ten years of his life, Sutherland described the PRM
being generated by external forces. He sensed his patients
being moved by an external ubiquitous force, which he called
the Breath of Life (BoL). Sutherland perceived the BoL to be an
incarnate process, passing through the patient’s body and the
Sutherland studies the cranial bones and their sutures and foraminae
Sutherland begins experimenting with the dura and its infoldings (falx, tent)
Sutherland shifts his focus to the fluctuation of cerebrospinal fluid and elucidates the
Primary Respiratory Mechanism
Sutherland describes the Breath of Life
Sutherlalnd begins working with Tidal potency
Sutherland stops motion testing, all fulcra occur in still points
Sutherland’s writings are published, after editing by Ada Sutherland and Anne Wales
Sutherland’s students Rollin Becker and Robert Fulford expand his post-1943 work
Jealous links Sutherland’s insights to the works of Blechschmidt and van der Post
Bar Harbor: at a meeting of osteopaths from England New England, James
Figure 1. A chronology OCF and BOCF evolution.
Biodynamic Model of Osteopathy EXPLORE January 2005, Vol. 1, No. 1
practitioner’s hands, undiminished. With the BoL concept
Sutherland’s reverence for a self-correcting system had fully
ﬂowered. “Sutherland arrived at a conceptual transition, leav-
ing those who followed with a bridge to the depth of osteo-
pathic research and practice that places us upon a new and
deeply challenging renewal of the ultimate truths of our pro-
fession” ( Jealous 1997). Sutherland’s bridge linked his stu-
dents to Still’s earlier insights, such as “Life is the highest
known force in the universe” and “We are the children of a
greater mind” ( Still 1902).
In the ﬁnal years of his life, Sutherland’s perceptual lan-
guage drew upon the natural world around his home in Paciﬁc
Grove, California. He spoke of his patients as if they were part
of a sea, with waves that rhythmically move through the wa-
ter, and a tide that moves deeper, through both water and
waves ( Sutherland 1967). Sutherland was describing a poly-
rhythmic system (see Table 1). As the BoL transubstantiates
into the PRM, it generates various harmonic rhythms in the
body, such as the “Long Tide,” the “300 second cycle,” the “2
to 3 cycle,” and the CRI. Becker (1965) described the Long
Tide as the basal rhythm, its rate directly correlating with that
of the BoL, oscillating at a frequency of 6 cycles every 10
minutes. Around 1988 Jealous described the “2 to 3” (aka the
CPM cycle) with a mean frequency of 2.5 cycles/min
(Jealous 1997). The 2
CPM is a harmonic of the Long Tide.
It is not modulated by the central or autonomic nervous
systems, making it a stable rhythm. Liem (2003) described the
300 second cycle, which has also been described by others.
Polyrhythms may explain the poor agreement seen in some
OCF inter-examiner reliability studies. For example, the in-
ter-examiner study by Norton (1996), reported low reliability
between OCF practitioners. This study was ﬂawed because
one practitioner recorded the CRI rate while the other prac-
titioner recorded the 2
CPM cycle ( Jealous, personal com-
Sutherland (1990) compared the BoL to the cyclic, sweeping
beam of light emitted from a lighthouse, “lighting up the ocean
but not touching it.” The BoL sweeps through the patient, en-
lightening the healing forces already present in the patient. This
allows the “Fluid Body” to emerge, where the whole body be-
haves as if it were a single unit of living substance. The Fluid
Body represents the BOCF equivalent of a Bose-Einstein con-
densate, where individual molecules lose their identity and form
a cloud that behaves as a single entity ( Cornell & Wieman,
EVOLUTION OF PERCEPTUAL SKILLS
Sutherland’s initial osseous approach to OCF requires a sound
palpatory comprehension of all surface landmarks of the cra-
nium, at all stages of human development. This includes the
contours of the 22 cranial bones, their interlocking articulations,
and many ﬁssures and foraminae. Normal and abnormal levels
of tonus in extracranial muscles must also be appreciated, as well
as tissue texture changes in cutaneous tissues.
The dural model of OCF, like the osseous approach, requires a
comprehensive grasp of anatomy. Perceptually, sensing the dura
and the reciprocal tension mechanism requires the practitioner
to palpate tissues beyond his or her ﬁngertips. This seeming
esoteric skill is familiar to anyone who has driven an automobile
on wet roads–feeling a slippery road surface through the steering
wheel, sensing the road surface indirectly, through a series of
linkages from the road through the tires through the wheel axles
through the steering wheel.
For practitioners working with the CSF and ﬂuid ﬂuctuations,
anatomical knowledge is not sufﬁcient. Rollin Becker admon-
ished, “Studying the cadaver is like studying a telephone pole to
ﬁnd out how a tree works” ( Speece et al 2001). The requisite
education comes from a study of living tissues in one’s patients.
The practitioner visualizes “a state of rapport in the ﬂuid conti-
nuity between the physician and the patient” ( Magoun 1976) by
“melding the hands with the head” ( Upledger & Vredevoogd
1983). With training and practice the practitioner feels a subtle
motion, much like the respiratory excursion of the chest, sensed
as a broadening and narrowing of the head between the hands.
This type of palpation represents a harmonic signal of several
senses, including temperature receptors, mechanoreceptors, and
proprioceptors ( McPartland & Mein 1997). Other yet-uneluci-
dated sensors may detect piezoelectricity or electrical ﬁelds as
described by yogic practitioners ( Green 1983). Milne (1998)
achieved “visionary craniosacral perception” by entraining his
diaphragmatic breath, empathy, and intent with those of his
Detecting polyrhythms and the Fluid Body requires practitio-
ners to augment their “afferent” activity and reduce their “effer-
ent” activity. In other words, practitioners must emphasize re-
ception rather than transmission. This is the difference between
listening to a radio and conversing on a cell phone. Even “meld-
ing the hands with the head” may be too efferent. Conveying
efferent forces into a patient creates a jumbled sense of “I-thou.”
To detect the Long Tide and the 2
CPM cycle requires defa-
cilitation of the practitioner’s central nervous system ( Jealous
2001). Our consciousness, like our spinal cord, can become
facilitated and noisy. According to Jealous, a quiet mind requires
the cranial, thoracic, and pelvic diaphragms to function without
inhibition. This is accomplished by allowing the breath to be-
come slow and regular, and by softening the muscles above the
Table 1. Polyrhythmic Cycles Described in OCF and BOCF
Cycle name Cycle rate Cycle source
6-12 cycles/min Unknown. Possibly
or pre-Neutral CNS
CPM cycle 2.5 cycles/min Primary Respiration
Long Tide 0.6 cycles/min Breath of Life
300 second cycle 0.2 cycles/min Unknown. Possibly a
24 EXPLORE January 2005, Vol. 1, No. 1 Biodynamic Model of Osteopathy
pubic bone. These actions reportedly serve to “synchronize the
practitioner’s attention.” As attention synchronizes and has
room to breath, the practitioner senses deeper rhythms, and the
signal shifts from the CRI rate to the 2
CPM cycle. With
deeper defacilitation, perception of the 2
CPM cycle disap-
pears into the Long Tide ( Jealous 2001).
With enhanced perceptual skills, the practitioner eventually
perceives a sense of Neutral, which is experienced as a homoge-
nization of tissue, ﬂuid, and potency–the Fluid Body, where
nothing under the ﬁngertips can be discerned as a separate en-
tity. This lysergic entity lies at the perceptual center of BOCF.
The Neutral cannot be conceptualized; it can only be experi-
enced. It is here that “holism” becomes more than a philosoph-
ical concept, it can be appreciated as an actual sensory percep-
tion. A summary of some of the differences between OCF and
BOCF are presented in Table 2.
EVOLUTION OF TREATMENT APPROACHES
Directly adjusting sutures and foraminae affects the function of
cranial nerves and vessels that traverse these apertures, as well as
the function of muscles that originate or insert upon cranial
bones. Some of Sutherland’s students continue to focus on
bones and sutures, such as the American chiropractor De-
Johnette, who founded Sacral-Occipital Technique ( Hesse
1991). Treatment of suboccipital muscles directly impacts the
dura and may be helpful in patients with dural headaches and
chronic pain syndromes ( McPartland et al 1997).
Treating the reciprocal tension membrane with balanced mem-
branous tension (BMT) is an indirect technique, performed by
gently exaggerating the membrane’s strain patterns, balancing
the tension in strained ﬁbers with the tension present in normal
ﬁbers, effecting a release of the strain ( Sutherland 1990). Many
osteopaths work with this dural model and get good results.
Lawrence Jones used his counterstrain technique to mould the
falx and the tent. Beryl Arbuckle was an extraordinarily gifted
practitioner of BMT.
Sutherland initially used direct hydraulic force, such as the CV4
technique for compressing CSF in the 4th ventricle ( Magoun
1976, Upledger & Vredevoogd 1983). The CV4 induces thera-
peutic changes around the body, possibly via periaqueductal
gray (PAG) tissue, which surrounds the 4th ventricle. The PAG is
lined with neuroreceptors (opioid and cannabinoid receptors),
and it responds to stimuli (such as hydraulic pressure) by acti-
vating these neuroreceptors, by releasing endorphins and endo-
cannabinoids, and by propagating pain-inhibitory signals to the
dorsal horn. The PAG is homuncular, like the somatosensory
cortex, so the topography of the PAG corresponds to different
parts of the body (J. Giodarno, personal communication, 2002).
Most practitioners who work with the rhythmic ﬂuctuation of
CSF focus upon the CRI rate, as exampled by Magoun’s and
Updelger’s models. The CRI rate is also the focus of the Suther-
land Cranial Teaching Foundation (SCTF), although the SCTF
now incorporates the 2
CPM cycle and the Long Tide into
their curriculum (A. Norrie, personal communication, 2002).
CRI-oriented practitioners may bring about therapeutic
changes by inducing entrainment ( McPartland & Mein 1997).
Entrainment was ﬁrst described in 1665 by Christiaan Huygens
( Strogatz & Stewart 1993). He noted that collections of pendu-
lum clocks began swinging in synchrony with each other. This
coupling phenomenon also arises within organisms (eg, cardiac
pacemaker cells) and between organisms (eg, simultaneously
ﬂashing ﬁreﬂies, harmoniously chirping crickets, and women
Table 2. Brief Comparison of Biomechanical and Biodynamic Models of OCF
Techniques led by practitioner’s forces, directly
Techniques follow movement within the system. Transmutative ability of the Tide
is acknowledged. Tidal forces directly interface with pattern of disease.
Practitioner follows closely.
Axial motion in bones Motion is translational, transmutational, metabolic.
“Mechanism” used as a non distinct collective
“Mechanism” deﬁned through speciﬁc elements (ie, Breath of Life, Fluid Drive,
Tidal Forces, different rates, and others) Words have sensory foundations that
are clearly stated.
CRI is a primary expression of the BoL CRI is not an expression of the BoL nor is it a therapeutic force.
CRI 8-14 cycles per minute. Slower rates not
Basic rate is 2-3 cycles per minute; slower rates are speciﬁcally identiﬁed as
primary to the system.
Perception is automatic. Skills not delineated Perception is a conscious, skillful act, requiring training and moment-to-moment
adjustment, not automatic.
Lesions are somatic and articular in nature Lesions may occur at any level in the system. A lesion is seen as a unit of
dysfunction in the Whole person.
SBS is a primary site of orientation for lesion
activity. Lesions are diagnosed and reduced
by conceptual sequences beginning at SBS
Primary site is variable. Lesions are not automatically corrected; sequences are
not conceptual. Priorities are established by the Tide.
Biodynamic Model of Osteopathy EXPLORE January 2005, Vol. 1, No. 1
whose menstrual phases cycle together). Huygens noted that
“strongest” clocks (those with the heaviest pendulums) estab-
lished the eventual, overall rhythm. ( McPartland & Mein 1997)
proposed that practitioners transferred their “strong clock”
rhythms onto their patients, and enhanced this transfer by as-
suming a meditative state before treating patients. Meditative,
centered states are known to produce strong entrainment ( Tiller
et al 1996). Centering to harness entrainment may be a wide-
spread therapeutic technique, albeit unrecognized by practitio-
ners of Feldenkrais, Network Chiropractic, Polarity therapy,
Reiki, Therapeutic Touch, and Tragering. Chinese practitioners
center on tan tien, the “one point,” about 5 cm above the pubic
bone, whereas Tibetan practitioners meditate on an image of the
Medicine Buddha centered at sahar chakrã, the crown of the head
( McPartland 1989). The new “Freeze-Frame” technique focuses
on the heart to achieve entrainment ( Tiller et al 1996). All these
techniques center attention on parts of the body rich in biolog-
ical oscillators (intestines, brain, and heart).
Tiller et al (1996) stated that feelings of empathy and love lead
to strong entrainment. Jahn (1996) described the resonant bond
between practitioner and patient as a form of love, transmitting
“beneﬁcial information.” Wirkus (1992) emphasized that the
healer “. . .must feel and be the heart chakra. . . It is not thinking
the word ‘love,’ it is the real sensation of pure love which brings
warmth, delicate vibrations in your heart area.” Fulford (1988)
was precise: “You the [practitioner] stand neutral, acting as a
conduit for the ﬂow of divine love. As you learn to use love
properly in healing work, your body vibrations increase and it
becomes easier to handle the potency of the love energy.”
Entrainment has its limitations. It can only be employed by
practitioners who work with the CRI. Practitioners working with
slower rhythms avoid efferent activity, so no entrainment may
be possible, or desired. We limit our therapeutic potential when
we focus solely on the CNS–whether we work with the CSF like
Sutherland’s early years, or the cellular vibrations of entrain-
ment. We may also cause side effects and iatrogenesis ( Green-
man & McPartland 1995, McPartland 1996).
According to a précis by Jealous (personal communication,
2004), “Cranial osteopathy is not about the cranium. It is about
Primary Respiration.” Sutherland’s move from the CSF to the
Fluid Body began with a technique he called “automatic shift-
ing.” Paulsen (1953) described Sutherland’s sensation of a “mo-
tor” starting in the CSF and then carrying on of its own accord,
generating a healing force that treated several lesions around the
body. “The core of this work is perceptual,” wrote ( Jealous 2001),
“We learn to sense the Whole. When one meets a patient, one
sees the Whole—a very rare event in our modern world.” When
a patient achieves a Neutral as described previously, the CNS
becomes quiet (the person often falls asleep). With the CNS
“out of the way,” the whole person—the CNS, CSF, all other
ﬂuids, and all other tissues—merges into the Fluid Body. Within
the protoplasmic Fluid Body, motion is purely metabolic, re-
sponding freely to the outside presence of the natural world and
To harness the potency present in the BoL as expressed in the
Tide requires ever-more subtle techniques. In the ﬁnal years of
his career, Sutherland stopped all motion testing of the head,
and applied no forces to osteopathic lesions. He worked with
fulcrums in still points, and stated, “treat not with techniques
but gentle contact” ( Sutherland 1990). Working with the Health
is a BOCF imperative, echoing Still (1899), “To ﬁnd health
should be the object of the doctor. Anyone can ﬁnd disease.”
Jealous (1997) described therapeutic changes requiring an “ab-
original and instinctual consciousness” on the part of the prac-
titioner, not intellectual or even intuitive, “The moment is ﬁlled
with the effort to be present with the Health in the patient and
the story as it unfolds into its own answer.”
BOCF SCIENCE: QUANTUM CONSCIOUSNESS
Osteopaths base their science in physics, whereas Western med-
ical practitioners practice chemistry–their pharmacodynamic
tools treat chemical moieties known as genes and gene products.
Osteopaths recognize the A-T-C-G chemistry of genes, but focus
on the physics of the midline within the double helix itself. To
wit, osteopaths focus on the double helix’s fourth dimension:
Time. DNA converts time into space. Surprisingly, this transmu-
tation can be explained within the mechanistic model of New-
tonian physics ( Pourquié 2003). Many new ideas proposed by
New Age healers operate within a Newtonian paradigm. Pert
(2000) hypothesized that energy therapists heal their patients by
inducing a vibrational tone that shifts neuroreceptors into their
constitutively-active state, or the vibrations trigger the release of
endorphins that active the neuroreceptors Oschman (2000) de-
scribed crystalline materials within biological structures (eg,
phospholipids within cell membranes, collagen in connective
tissues) that generate electric ﬁelds when compressed or
stretched (piezoelectricity). These energy ﬁelds may be the
source of hands-on healing, a radical proposition, but safe within
a mechanistic paradigm.
Newtonian physics has undergone a paradigm shift to Quan-
tum physics, thanks to relativistic studies addressing subatomic
phenomena and consciousness. Still’s writings suggest he had
undergone a Quantum paradigm shift. He knew intuitively that
the healing events in his patients happened at the subatomic
level, but he did not have the words or the concepts of Quantum
physics to draw upon, to express the transformation he was
experiencing in his treatments. Instead, he ascribed the return to
health to God or Divine Nature at work.
Sutherland’s BoL exhibits characteristics that can only be ex-
plained by Quantum theory (eg, the theory of implicate order by
Bohm 1980). The BoL transubstantiates into primary respira-
tion, a ﬁeld force that generates a spatial orientation, so it shares
characteristics with the “morphogenetic ﬁelds” described by
Sheldrake (1981). Sheldrake’s concepts are very Quantum: Mor-
phogenetic ﬁelds carry information only (no energy) and are
available throughout time and space without any loss of inten-
sity after they have been created. These nonphysical “blueprints”
guide the formation of physical forms through three-dimen-
sional patterns of vibration he called morphic resonance. The mor-
phic resonance that generates form in the embryo is the same
process that generates healing in the adult.
The role of consciousness in Quantum theory is a radical
departure from classical physics. The outcome of any experi-
26 EXPLORE January 2005, Vol. 1, No. 1 Biodynamic Model of Osteopathy
ment depends upon the consciousness of the observer. Indeed,
the term observer should be replaced by the term participator.We
cannot observe the universe, we are participants in it. Our indi-
vidual consciousness is a small hologram of the universal con-
sciousness shared by all living things. Capra (1996) named con-
sciousness (“the process of knowing”) as a key feature of life,
including life forms such as plants and protozoans that lack a
central nervous system. The protoplasmic Fluid Body shares this
consciousness, which explains its “sensitive” and “decision-mak-
ing” attributes ( Jealous 2001).
From a BOCF perspective, Jealous (2001) acknowledged that
the practitioner’s consciousness has a primary role in the depth
of therapeutic changes arising in the patient. Jealous discovered
that his therapeutic results improved in proportion to the extent
to which he could free himself from conscious rationalization.
He discovered, as did Sutherland, that the practitioner’s effort
“. . .is to let the Breath of Life move us, allow us vision. . . One’s
effort must be from a ‘sense of the possibilities’” ( Jealous 2001).
The next couple sections of this article review new research
“around the edges” of BOCF science.
BLECHSCHMIDT’S EMBRYOLOGY VIA ÀVIS THE BOL
Jealous (2001) characterized traditional osteopathy as a science
based on anatomy, whereas BOCF is a science based on embry-
ology. BoL practitioners have followed the work of Erich Blech-
schmidt (1902–1992), an unabashedly holistic embryologist. Ac-
cording to Blechschmidt (1977), each part of the embryo
develops in motion, and each motion impacts the development
of each subsequent motion. Early embryological development is
largely epigenetic, guided by ﬂuid dynamics. Blechschmidt’s con-
cepts agree with BOCF practitioners, who postulate that the
BoL, the external force described by Sutherland, generates a
spatial orientation in the embryo. The spatial orientation be-
comes expressed in the material plane by ﬂuid forces, perhaps by
electromagnetic water hydrogen bonds (a concept that resonates
with the “water imprint” theory of homeopathy), generating a
matrix that governs the embryo’s development. This conceptual
agreement between Blechschmidt and BOCF places them on
one side of a great debate. For the past 50 years scientists have
argued over two theories regarding embryonic development: is it
passive and “external,” driven by ﬂuid dynamics, or active and
“internal,” driven by the molecular activity of genes?
Neural crest cells (NCCs) are a focus of this debate. Migratory
NCCs appear in the fourth week of human embryogenesis. As
the lateral edges of the neural plate fold up and fuse at midline to
form the neural tube, NCCs surf the crest of the wave generated
by this zipper-like action. NCCs follow highly replicated, stereo-
typical pathways. In our age of molecular medicine, advocates of
active cell migration uphold the dominant paradigm. According
to this view, migrating NCCs are directed by genes that express
cell membrane receptors. NCC receptors sense molecular gradi-
ents in the extracellular ﬂuid. Thus NCC migration has been
described as chemotaxic, guided by molecules such as integrins,
cadherins, and connexins ( Maschhoff and Baldwin 2000). This
molecular view is challenged, however, by phylogenetic incon-
sistencies–NCCs only appear in vertebrate embryos. Inverte-
brate embryos have no NCCs yet they express genes linked with
NCC migration, such as BMP2/4, Pax3/7, Msx, Dll and Snail
(Holland & Holland 2001). Vice versa, genes associated with
vertebrate cell migration, such as CNR1 ( Song and Zhong 2000)
are absent in invertebrates ( McPartland et al 2001, McPartland &
Glass 2001). Plants, which are devoid of a CNS, also express
integrin receptors ( Lynch et al 1998), which aid plant cells
in the perception of gravity (a very subtle force in non-ferrous
materials). Perhaps integrin receptors are not chemotaxic guides,
but in fact respond to subtle electromagnetic forces such as the
Blechschmidt argued that ﬂuid dynamics permit migrating
cells to overcome the inertial, thixotropic (viscous) behavior of
embryonic extracellular ﬂuid. The tensile quality of the ﬂuid
matrix provides a scaffolding for the migration and movement
of NCCs. BOCF practitioners correlate this concept with Suth-
erland’s description of the Tide acting as a ﬂuid within a ﬂuid,
expressing a tensile quality, with the ability to direct force. Blech-
schmidt’s theory has been veriﬁed by researchers around the
world (see a dozen citations in Jesuthasan 1997) who injected
latex beads into living embryos. Latex beads are inert objects
incapable of molecular chemotaxis and lack inherent motility.
They nevertheless follow the migratory pathways of NCCs. The
tensile ﬂuid forces required for this kind of movement were
demonstrated by Schwenk (1996), who used micropipettes to
inject streams of ﬂuids into water. Boundary surfaces arising
between the moving ﬂuid and the still water vortexed into or-
ganic forms (see Figure 2). Experimental changes in ﬂuid density
or injection speed created different forms. In some experiments,
the tensile quality of the ﬂuid matrix created shapes that resem-
Figure 2. Photomicrograph of micropipette injecting a stream of ﬂuid
into water, forming a vortex. The boundary surface between the
moving ﬂuid and the still water creates organic forms. Illustration by
Gerald Moonen, redrawn from Schwenk (1996).
Biodynamic Model of Osteopathy EXPLORE January 2005, Vol. 1, No. 1
bled the migratory path of neural crest cells. In other experi-
ments the spatial orientations of ﬂuid-in-a-ﬂuid suggested CNS
formation in the embryo, complete with dura and pia, cerebral
hemispheres, and a corpus callosum connected the hemispheres
(see Figure 3). Schwenk’s experiments with ﬂuid mechanics sug-
gested that the geometric conﬁguration of the embryo is present
before the structure develops.
After the ﬂuids lay down a matrix or blueprint, genetic expres-
sion subsequently organizes the cells, and cell migration does
indeed become active. For example, the initial wave of NCCs
stops migrating and establishes a reticular lattice. This lattice
provides a scaffolding for the active chemotaxic growth of neu-
rons, presaging the mature organization of the autonomic ner-
vous system ( Conner et al 2003).
Similar phenomena govern the growth of neurons, via a sen-
sory and motor apparatus in their tip termed the growth cone.
Growth cone pathﬁnding is partially guided by ﬂuid forces, a
passive process again demonstrated by the translocation of inert
latex beads ( Newman et al 1985). But genes also contribute to
growth cone pathﬁnding, by expressing cell membrane receptors
that are activated by extracellular “attractant” or “repellent”
compounds. For example UNC-40 and Eph receptors are acti-
vated by netrins and ephrins, proteins secreted into extracellular
ﬂuid. Activated UNC-40 and Eph receptors begin a molecular
cascade that directs the cell’s actin cytoskeleton, thereby regulat-
ing growth cone motility ( Dickson 2002). A veritable molecular
soup guides neurons to their destinations. This complexity can
be appreciated by the daunting task faced by commissural axons,
which must grow towards the midline, cross it, and then con-
tinue on their path without turning back.
Nevertheless, Blechschmidt emphasized that genes do not
act, they react to external forces. The reaction of genes to hydro-
static pressure during embryogenesis has recently been termed
“the morphogenetic mechanism” ( Van Essen 1997). Wal (1997)
likened genes to the clay that forms a piece of pottery. Clay by
itself by itself cannot form into shape; it requires the hands of
the artist. And the hands of the artist cannot act without the
mind of the artist. From a BOCF perspective, clay represents the
genes, the hands represents the ﬂuid forces, and the artist’s mind
represents the BoL—the “deiﬁc plan” or the “master mechanic”
often alluded to by A.T. Still. Anecdotally, we (J.M. and E.S.)
attended a BOCF workshop the week that Venter et al (2001)
published the human genome sequence. While scientists around
the world pondered the paradox that an organism of our com-
plexity could operate on only 30,000 genes ( Claverie 2001), our
workshop of BOCF practitioners conﬁrmed the obvious neces-
sity for epigenetic forces to make “decisions” that shape embry-
Blechschmidt (1977) elaborated six different mechanisms by
which ﬂuids “behave internally,” creating function out of which
emerges structure: contusion, distusion, dilatation, retension,
detraction, and densation. Later he added corrosion, loosening,
and suction mechanisms ( Blechschmidt & Gasser 1978). These
mechanisms are driven by the metabolism of cellular tissues.
Cell metabolism potentizes or depletes various ﬂuids, which
Blechschmidt termed “metabolic ﬁelds.” For example, the earli-
est bending of the embryonic disc (ﬂexing into a “C” shape) is
due to a decrease in pressure from the collapse of the yolk sac
( Drews 1995). Cellular metabolism depletes nutrients in extra-
cellular ﬂuids, and causes a build-up of metabolic wastes. Sheets
of cells adjacent to depleted ﬂuids slow their growth, and be-
come the concavity of tissue curvatures. Concentration gradi-
ents of nutrients and wastes create ﬂuid movements between
sources and sinks. When these ﬂuid movements cannulize tis-
sues they become embryonic blood vessels.
Sheets of cells, tissues, and organs grow at different rates.
The epithelial linings of these assemblages become restrain-
ing structures, generating form. The embryonic face, for ex-
ample, arises as folds and furrows between an expanding brain
and a beating heart ( Blechschmidt & Gasser 1978). Growth
differentials within the embryonic cranium create ﬂuid pat-
terns that later condense into mechanical tension zones or
mesenchymal restraining bands known as the dural girdles.
Figure 3. hotomicrograph of micropipette injecting a stream of ﬂuid
into water, an experimental variation from Figure 4, changing the
density of the ﬂuid. The spatial orientation of boundary surfaces
suggests that of embryonic CNS formation. Illustration by Gerald
Moonen, redrawn from Schwenk (1996).
28 EXPLORE January 2005, Vol. 1, No. 1 Biodynamic Model of Osteopathy
They guide the position, shape, and inner structure of the
brain, “The resistances are not crude mechanical forces but
delicate living developmental resistances” ( Blechshmidt
1961). The midline dural girdle between the cerebral hemi-
spheres serve as a strong restrainer against the pull of the
descending viscera and the eccentric growth of the cerebrum.
This midline dural girdle is retained into adulthood as the falx
cerebri. It initially cleaves the frontal bone, which is why the
frontal bone, a single midline structure in most adults, func-
tionally behaves like a paired bone. In some individuals this
midline function is retained as structure, the metopic suture
( Magoun 1976). Several paired dural girdles arise in the em-
bryo, and one of them is retained into adulthood as the
Another aspect of embryology that informs BOCF is the
concept of a functional midline, around which our bodies and
health must organize. The midline is the earliest expression of
function within the embryo. A series of structures arises from
the midline – ﬁrst the primitive streak appears in the ecto-
derm, beginning at the caudal pole of the embryonic disc.
Subsequently, the notochord develops within the endoderm,
again growing from caudad to craniad. Days later, the neural
groove forms along the midline, arising tail to head. During
the fourth week of development, the neural tube closes at its
two ends, and the movement of ﬂuid is no longer a circulation,
but a ﬂuctuation. The amniotic ﬂuid becomes the CSF. The
lamina terminalis marks the closure of the cephalgic end of
the tube. This midline structure persists in the adult, at the
roof of the third ventricle. It is the pivot point for all neural
movement. During the inhalation phase of the PRM (ie, the
“inspiration” phase), the entire central nervous system spi-
rally converges upon lamina terminalis. During the exhala-
tion phase, all tissues move away from lamina terminalis.
Jealous (1997) described the midline arising from the Still-
ness, generated by the BoL. The functional midline remains
present throughout our life, and our structure and physiolog-
ical motion remain oriented to the midline. The BoL comes
into the body at the coccyx and ascends along the midline,
radiating “like a fountain spray of life” ( Sills 1999). The con-
veyance of a midline bioenergetic force from tail to head has
been described by numerous workers, perhaps ﬁrst by the
medical polymath Wilhelm Reich. Reich and his students
independently described the PRM, “. . .conﬁrmation of brain
movement can be obtained from individuals who are free of
armoring. . . this movement is relatively slow and unrelated
to arterial pulsations” ( Konia 1980). Interestingly, genetic
mechanisms tend to work in the opposite direction, in a
cephalad to caudad progression. This is best exempliﬁed by
the activation of a dozen Hox transcription factor genes (the
“Hox clock”) that direct the formation of embryonic somites
from head to tail. The sequence of Hox gene expression is
collinear with their gene order on the chromosome ( Kmita &
The movement of the Tide can be palpated throughout the
body, termed “Zone A” by BOCF practitioners ( Jealous
2001). Asian practitioners conceptualize this energy moving
in channels, such as Chinese chi and Ayurvedic vata and its
subdosha prana ( McPartland & Foster 2002). The movement
of the Tide can also be palpated outside the body, in the
“auric ﬁeld” of various Eastern and Western energy workers,
termed Zone B in BOCF lexicon. Osteopaths such as Ran-
dolph Stone and Robert Fulford primarily worked in Zone B.
Rollin Becker worked in Zone C, a ﬁeld diffusing from the
midline to the edges of the room (personal communication, J.
Jealous, 1999). Jealous (2001) emphasized that all these zones
exist simultaneously, as do other domains, such as Zone D,
which extends from the patient’s midline to the horizon. The
zones are useful diagnostic tools, augmenting the practitio-
ner’s perceptual ﬁelds.
EMBRYOLOGY LEARNS FROM BOCF
BOCF has learned from embryology, but the relationship is
reciprocal–BOCF has informed the science of embryology.
Take the anterior dural girdle (ADG) for an example. The
ADG arises around the 8th week of pregnancy, as a conden-
sate of strain patterns between the evaginating telencephaic
vesicles (Figure 4). According to most embryologists, the
Figure 4. The anterior dural girdle forming in an 8 week old embryo,
drawn as a thin double line between anterior and lateral telencephalic
vesicles. Illustration by McPartland, redrawn from Blechschmidt &
Biodynamic Model of Osteopathy EXPLORE January 2005, Vol. 1, No. 1
ADG regresses before birth. However, one of Jealous’s col-
leagues alerted him to a cranial strain pattern that he detected
in several of his adult patients. They started calling it “the
hoop,” describing its sensory feel. They organized perinatal
dissections with Frank Willard, PhD, and discovered that the
anterior dural girdle does not always involute before birth,
but sometimes remains as an anterior transverse septum (Fig-
ure 5). In other cases the girdle regresses, although a strain
pattern may remain in the ﬂuids.
BOCF palpation also presaged the discovery of a dural bridge
in the suboccipital region (Jealous, personal communication,
1999), and this structure is now known to persist in adults ( Mc-
Partland & Brodeur 1999). The dural bridge attaches the dura to
the posterior atlanto-occipital membrane (PAOM), a ligament
that spans the OA joint.
CARE AND FEEDING OF THE ATTENTION FACULTY
BOCF is taught within a clinically based programme, where
each step is designed as a journey to reawaken the intuitive
and instinctual aspects of the practitioner’s mind. Our intui-
tive and instinctual faculties were called “primary percep-
tions” by Pearce (1977), who described them as “part of na-
ture’s built-in system for communication and rapport with
the earth.” These abilities tend to disappear, like muscle atro-
phy, if they go unused. Thus intuition and instinct are present
at birth, but wither due to lack of use given today’s societal
and educational burdens. Our intuition, instinct, and percep-
tual vitality are also dulled by the stress of urban living, and
by the pressures of our professional life.
Great care is taken in the choice of where practitioners
receive BOCF training. The natural world is a necessary par-
ticipant and instructor. Through his own experiences in the
wildernesses of New England and Canada, Jealous learned
how the deeper self, the human spirit, emerges upon encoun-
tering the nature world. Nature’s “spell of the sensuous” qui-
ets a person’s CNS, allowing boundaries to fall away between
the individual and the whole. John Muir, a 19th century
American naturalist, spoke like an osteopath, “In nature,
when we try to pick out anything by itself, we ﬁnd it hitched
to everything else in the universe” ( Muir 1911). The BOCF
practitioner transports this natural-world phenomenon to the
urban treatment room, incorporating an indigenous state of
consciousness into everyday clinical practice.
It is important to recognise that what is observed during the
course of treatment is not the result of mesmerism, coloured
by a vaguely vitalistic theory, but evidence of a precisely
organised natural system which requires discipline and dedi-
cation in order to develop the practitioner’s perceptual fac-
ulty. Practitioners at this time in history are in a unique
position. Given our training in medical science and hands-on
manipulative techniques, combined with the principles of
Still and Sutherland, we can consult with the blueprint for
health, namely, embryological growth and development reca-
pitulated as the forces of healing. But there is a caveat: with-
out the proper preparation, this approach can be dangerous
for the patient and an abuse of the practitioner’s commitment
to the Hippocratic Oath. This model does not work with
“energy” but with the consciousness of the natural world.
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