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There are multiple ways of understanding human health and disease.

The standard medical

approach seeks to take what is known and to piece things together in an effort to construct a
model that explains how things are, to build a Lego model or a jigsaw puzzle from small bits of
information. The osteopathic mode of understanding is different. It seeks to comprehend the
whole and the relationship of its parts. Without such understanding the movement of life cannot
be held with the reverence it deserves.
Both ways of thinking have their value and insights. Medicine rightly finds the primary cause of
infectious disease to be bacteria or viruses. Medical science discovered that when the infectious
agent can be killed or prevented from contacting potential victims that an infectious disease can
be eliminated. Late in his career, Louis Pasteur proposed le terrain est tout Which Google
translates from the French as the terrain is everything. This is a recognition that the condition
of the body and the tissues influences whether or not an infection can get a foothold. (It may
also imply that preparation of individuals with vaccines can prevent disease).
The idea of anatomy as terrain is consistent with the osteopathic way of thinking about health
and prevention of disease. Most people recognize the role of stress in becoming susceptible to a
cold or flu infection. The stress may be emotional, lack of sleep, prolonged exposure to the
elements, etc. Stress in some way alters the terrain of the body to make it more susceptible to
infection. Dysfunctions or lesions in the body that alter the flow of nutrition or removal of waste
products can also prevent the immune system from reaching a target leaving a region of the body
susceptible to infection. These dysfunctions can take different forms. The issue may be a
problem with the spine that impacts the nervous system, impacting the tone of the blood vessels
which in turn causes poor nutrition to the tissues the blood vessels supply. The lesion may be a
distortion of a joint which causes tension in the fascia (connective tissues) creating a constriction
or log jam that prevents normal blood flow. This can be a problem with the arterial blood
reaching an area or it can be a problem with venous or lymphatic return that leads to a stagnant
region where micro organisms can flourish. Examples would include pneumonia from a
restricted rib that impacts the local lymphatic pumping of the adjacent lung tissue and sinusitis as
an opportunistic infection from poor pumping of the sinuses via rhythmic motions of the
The approaches to treatment of standard medicine versus that of osteopathy differ as a result of
these differences in understanding. A child with earaches may be treated with antibiotics, tubes
through the eardrums to help the middle ear drain, antihistamines to reduce swelling from
allergic reactions, and or removal of lymph tissue that can block the drainage point
Eustachian/auditory tube. The traditional osteopathic approach would be directed at establishing
or restoring the normal mechanical relationships of the bones that make up the base of the skull.
The Eustachian tube has a bony portion in the temporal bone (the bone that the ear attaches to)
and then a cartilaginous portion either of which can be distorted by mechanical stress. The stress
of the bony portion can come from tension from adjacent skull bones or from tension in the
muscles that attach to it. Stress on the cartilaginous portion comes from unbalanced tension of
the muscles in the back of the throat which may be secondary to asymmetry of their bony
attachments. The osteopathic approach is to restore balance of joint contacts, balance of muscle
and connective tissue tension which allows the Eustachian tubes to drain the ear and to equalize
of pressure between the middle ear and the back of the throat. This eliminates the conditions that
create a cavity full of fluid that supports bacterial growth allowing the ear infection to develop.
Commonly the distortion of the base of the skull comes from the forces of labor and delivery or
other traumas to the flexible head of the child.