Treating the Whole Patient

Additional Core Osteopathic Concepts

The First Osteopathic Principle - How We Approach the Patient

The first osteopathic concept is the osteopathic approach toward the patient. We are looking at a whole patient. We are not just looking at the point which is producing symptoms and calling your attention to it. What is there in this whole child that is resulting in manifestation in a local area? The manifestation may be a neurological disturbance. This may be the hyperactive child who can't sit still through a meal, who can't sit still in school, who can't sit still period. The more the parents or the teachers say, "Sit still or you will go to the principal," the worse the activity becomes.

I wonder if any of you have a condition that is known by the title "restless legs"? Have you ever sat in a theater and thought you just couldn't keep your legs still? If someone had said to you, "Don't you dare move!" that would have made you much more susceptible to moving. So it is with this child who has an inherent neurological dysfunction that makes it impossible for him to be still. The more we try to pressure him to be still, the more restless he becomes.

There are many measures used to help these children. One may be to give them some medication, but the medication doesn't make them sit more quietly -- it dulls their intellectual awareness. They may sit still and, therefore, learn more to some degree, but they are not functioning at their capacity. That is a stop-gap measure. It hasn't done anything about the hyperactivity itself. In fact, the longer the child takes the drugs, the more difficult it is to break the habit because when the drug is stopped, the child becomes more hyperactive than when the drug was introduced in the first place.


What is the cause of the hyperactivity? Why does the child have to keep moving as if he is driven? Because he utilizes an external activity to make up for severe restriction in the inherent motion of these cranial bones and, therefore, all the structures that are related to them. They have to produce outside activity in order to make up for lack of internal activity.

It is not one area of the central nervous system that is involved, but the brain is in contact with every part of the nervous system in the body, and, therefore, we are concerned with the whole patient and not just one little area.

What we really are talking about is whole people, whether they be little people or big people, and recognizing that the structure of the body is intimately related to the way it functions. We might compare the body to a watch -- not one of the electronic ones, but the old-fashioned variety that had a lot of wheels and gears in it. If your watch started losing or started gaining time (or perhaps even stopped), and you took it to the watchmaker, you didn't ask him, "Which wheel is it that is causing the trouble?" He probably would say to you, "Well, your whole watch needs overhauling, so we can put it together so that every part works properly."


The body is like that too. It isn't just one piece that needs to be oiled and put back. The whole body needs to be integrated. The structure of the body is causative -- it is integrated.

Childhood is a time of falls and injuries. We are not only concerned with falls that broke bones or put the child in the hospital. We are concerned with any injury that happens to affect a critical part of this moving mechanism, and the only sign you may notice that it did that is when your child is less amenable to your directives. The tendency is to think he's naughty. As one osteopathic physician used to say, "Don't punish your children; treat them." You will find that when you treat them they change, and sometimes they change in an instant.

Some of the children come into the treatment room acting as if everything is wrong: they don't want any toys, don't want to play, don't want anything done. All of a sudden, when that mechanism begins to move -- "Can I have a toy, please?" It is absolutely phenomenal because it happens so fast. Once the key turns and the mechanism begins to move freely, the child becomes himself once more. It isn't always as simple as that because it may not have been just the last injury. It may have been an accumulation of injuries that have occurred, one after another, over several years; so, it doesn't always resolve immediately. But the principle is the same. It is that interrelationship of structure and function and the unity of the body functioning as a whole. It is not a series of isolated, independent parts.

The body has within it the process that heals itself. If that is true, then why haven't all your children been healed long ago? I'm sure you have all had the experience of a cut on your hand. Perhaps it was a deep cut, and perhaps it required some suturing and a dressing put on it. Then you were told to come back in five days for the doctor to take out the stitches. The doctor didn't heal the cut. Who did? You did. You healed your own cut. But sometimes, if something is not functioning properly in your body, you will go back at the end of five days and the cut has not healed.

The same may be true of a broken bone. The bone breaks, the surgeon approximates the two ends as closely together as he can, and then he mobilizes it in a plaster cast. He usually gives the instruction to come back in six weeks. It will probably be healed. But sometimes it isn't healed in six weeks. Sometimes it isn't healed in sixteen months because something is not working in the body to permit that inherent healing process to take place.


As osteopathic physicians we are very conscious of that inherent healing process. That healing process is not only concerned with knitting a bone together, healing a laceration, or overcoming an infection. It is also concerned with moving the body structure. Probably many of you have had the experience of doing some unaccustomed hard work, such as working in the garden once in three months. By the time you went to bed, every bone in your body felt as if it were out of place. But you went to bed and relaxed in sleep, and by the morning most of that was gone. Who did that work? You did. That inherent force in your body that is working to bring it to its optimum function did it. But if the strain or the restriction in that free motion has gone beyond a certain point, then the body needs a little help in overcoming it. However, if we can work with what the body is striving to do, then we shall get there much more quickly. Therefore, much of what we do is not visible. By that I mean we are not forcefully manipulating the body in this way and that way. We are detecting how that body wants to move, how it is striving to overcome its restrictions, and then just giving it a little help to do so.

Healing Starts Here....

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