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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION

ROLLIN E. BECKER, B.Sc., D.O.


Dallas, Texas

Diagnosis is an art and a science. In securing samples from the human adrenal Venus
the realm of science man has extended his blood flow by passing a cardiac catheter to the
senses through instrumentation and has brought left renal vein via the right saphenous vein and
in a battery of tests upon the human body and the inferior vena cava . With appropriate mani-
its contents. There are the usual urine tests, pulation, the catheters entered the central
simple blood tests, examination with the adrenal vein. Contrast media injections out-
electrocardiograph, the sphygomanometer, lined the adrenal venous network and the extent
opthalmoscope, otoscope, X-ray and other of the nonadrenal channels. Blood samples
instruments that can be found in the office. revealed levels of free cortisol ranging from
But this is barely a beginning. The patient 4 1 to 3 13 mcg . per 100 ml. of blood. This
can be taken to a fully equipped laboratory or technique will make it possible to study rapid
hospital and the variety of tests and the com- metabolic changes in the adrenal cortical
plexity of them are almost limitless. steroids.
Blood chemistries can be run that can de- Machines have been built that duplicate
fine the components of the blood stream down renal function so that serious renal dysfunctions
to the molecular level, for any given moment, can be handled for hours on end while work is
their electrolytic balances and a host of other being done to restore kidney functioning. Other
information. It is now possible to obtain an machines permit open heart surgery and chest
exact diagnosis of some virus diseases. surgery that could not be permitted a few years
Fluorescent antibody can be used to diagnose ago.
infectious disease by demonstrating antibody The use of electronics in the medical
and/or demonstrating antigen. Thus immuno- field is on the threshold of its development
logical controls of the body are becoming and already many electronic devices for
available for testing in the laboratory. Ma- diagnosis and study are making their way into
chines now give accurate blood counts for both the market. Electrocardiographic data can be
red cells and white cells, eliminating the human transmitted over a telephone circuit to any
error in making such counts. If there isn’t a place in the country. A Body Function Recorder
machine to do a differential count developed can keep a constant close surveillance on as
yet, human ingenuity should be able to come many as a dozen patients. Five variables can
up with an electric eye to do the seeing, a be watched simultaneously, the pulse rate,
small electronic brain to “remember” the systolic and diastolic blood pressure, the
different types of white cells, and a scanning temperature, and the air flow through the
device to make such a differential count, again nostrils. Miniaturization and transistorized
eliminating human error. equipment are making many tests permissible.
Enzymes, hormones, and other protein Blood pH can be monitored continuously for as
molecular actions and interactions are being long as six hours with a tiny electrode
analyzed and studied through a variety of l/20,000 inch in diameter, placed in a standard
approaches, electrophoresis , chromatographic hypodermic needle. At a glance, an attendant
processes, complex chemical techniques, can observe the concentration of carbon dioxide
radioisotopes, and the electron microscope. in the blood stream of an anesthetized patient,
Sampling for the various materials needed in the approach of shock in an accident case, or
these tests can now be taken directly from the the intake of oxygen in an iron-lung patient.
site of activity in many cases by the use of More and more of such devices will be available
catheters that are passed through the arteries with time to develop them.
and veins directly to the point from which a Thus the science of diagnosis is demon-
sample is desired. A recent report tells of strating its strength in every phase of human
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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION -- BECKER

existence and its potential for future develop- knowing touch. This latter I will enlarge upon
ment is practically unlimited. The physician later. Interpretative skills call for a knowledge
of forty years ago was a simple soul who ‘had a of functioning within the human body, function-
relatively few instruments at his command and ing that is related to past events leading to the
not too great an armamentarium of therapeutic present time he is seeing the patient, function-
aids with which to diagnose and treat the disease ing of the present time, and the ability to
and trauma of his patients. Today’s physician project functioning patterns into the near future.
must be a chemical engineer, an electrical This is different from the mere tests for function-
engineer, a biological engineer and a physical ing as recorded by the scientific tools at his
engineer, in addition to being a physician. The command. The latter are transitory findings
physician of forty years from now will make the that reflect the picture of the moment. True
present-day physician look like a simple soul. functioning within the individual patient is that
Thus the pattern continues to unfold. evaluation of what is being done by the patient
with all of these variables; how is his system
Diagnosis as an Art coordinating them; how is he adapting to the
dysfunctions, where is the potential for the
Diagnosis as an art is an important com- reversibilities of the dysfunctions. In other
ponent in the field of diagnosis. It has always words, how is this patient functioning as a
been. It always will be. Diagnosis as a science living being? He is sick. He comes to you
brings to the physician those data that can be for help. Where is he now, where was he when
learned objectively with the minimum of human his problems began, what is his potential for
error. The blood count that can be done by a return to normal? It is the intelligent use of
machine is more accurate than that run by a the physician’s eyes, ears and touch that can
technician counting the cells. So it is with all give him knowledgeable answers to some of
the biological detail that can be done by scien- these questions. There are variables found in
tific instruments. The art of diagnosis is that every case which must be taken into account.
ability applied by the physician himself. It These are the factors that complete the case.
involves the following factors: his interpreta- They are as important to the physician as the
tive skill in analyzing the data supplied to him vast array of scientific tools and the data there-
by his scientific tools and the use of his own from, perhaps more so, because these variables
personal skills in evaluating the patient before are the factors the patient is concerned about.
him. These are subjective in nature. These He is the one who is trying to get well.
may not bring the finite detail of the instrument
but neither are they limited by the finite detail Three Problems
that the instrument is only capable of perceiving.
There is room for variables, there is the ability There are always three problems every
to perceive past events, present events, and time a patient enters your office. There are
predictability for forecasting future changes, the patient’s ideas and beliefs of what he
There is a wider latitude of functioning in the considers his problem to be: there is the
subjective field in the art of diagnosis and this physician’s concept of what he considers the
coupled with the scientific data gives the patient’s problem to be; and, finally, there is
physician an over all picture that can bring a the problem of what the anatomical-physiological
more complete and knowledgeable diagnosis. wholeness of the patient’s body knows the
A scientific diagnosis is not enough. It is too problem to be.
limited. It is the composite use of both scien- The patient of today is a better informed
tific (objective) and personal (subjective) tools patient than the one of a few years ago. He
that gives the physician a true diagnosis. reads medical articles in the periodicals. He
Interpretative skills within the physician translates this information into his terminology,
are a subtle mixture of many years of training, not always correctly, and he has been to other
of knowledge of the available scientific tools physicians before coming to you. He has heard
and their use, of experience, of a mind that their diagnosis of his problem and adds that to
keeps itself open to any and all approaches his opinion. He tells you his story and tries to
that will enhance his abilities, of the develop- explain his physical feelings. He is sensitive
ment of his own personal subjective tools, his to your opinions and if you can come up with a
eyes in accurate inspection, his ears in accurate picture that will explain his problem to him in a
auscultation and percussion, his nose and taste satisfactory way, he is able to cooperate with
where indicated, and his thinking, feeling, you. But in the final analysis he still has his
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ACADEMY OF APPLIED OSTEOPATHY -- 1963 YEAR BOOK

opinion, right or wrong. this process, each physician will have to teach
The physician’s concept of what is wrong himself the details of the way into and through
with the patient is based upon a much more structure-function. It is a self-taught process.
highly trained set of factors. He has had many The steps of where and how to do this can give
years of rigid training, can run the necessary guidance but the physician himself is the final
tests and physical examinations to try to bring arbiter as to methods and results. We have to
the patient’s problem into focus, and is ab!e to learn to feel structure-function messages from
formulate a more objective diagnosis. He has within the body of the patient, not the end
been taught to try to create a diagnosis that is results of a test, but what is happening now,
couched in terminology with which he can when did it begin, how is it going to progress.
communicate his findings to the patient and to It is quite a challenge.
other physicians. For example, the diagnosis As indicated, the ability to understand
of a “peptic ulcer”, “viral pheumonia” or function-structure within living tissues is a
“whiplash injury” conveys a whole syndrome of self-taught process by each physician. Through
findings in the minds of other physicians to our eyes for accurate observation, our ears for
whom this same patient may present his case. accurate auscultation, we can learn some things
While this ability to communicate is necessary, that are happening to our patient. It is through
it is also a limiting factor in the true diagnosis. the sense of touch that we can learn a great
The body does not think of its problem in such a deal more about the patient. This is a touch
limited sense. But the physician has been designed to feel function within the tissues and
presented a problem and has formulated his to feel dysfunction when it is present. Function
diagnosis. has to be distinguished from motion. Motion is
Finally, there is the third problem. What not function; function always includes motion,
does this anatomical-physiological mechanism but motion, per se, does not represent all the
know about this case? It has the answer in values of function. Witness the patient who
every sense of the word from an over all pattern complains of a leg ache. We can test the leg
of total stress or disease down to the smallest for motion both passively and by voluntary
or infinite detail. The anatomical-physiological cooperation of the patient and find it working
mechanism and its structure-function or function- well according to motion. Yet the patient will
structure (structure-function and function-struc- say, “But, doctor, why does my leg hurt?”
ture are interchangeable) carry the total picture. With a touch designed to feel the dysfunction
The patient’s body has the answer written into within that leg causing it to ache, it is possible
and through the physiological functioning of to say, “I find the source of your disability to
his brain and nervous system, his circulatory be thus and so.”
patterns, his fluid balance interchange, his
organ systems, his endocrine makeup, his It is difficult to find words to describe
structure-function interrelationsl$ps . function within living tissues. It is an evalu-
T O sum it up as simply as possible, the ation that can be felt with a knowing touch
patient is intelligently guessing as to the similar to that experience of watching a patient
diagnosis, the physician is scientifically walk into your presence with a knowing visual
guessing as to the diagnosis but the patient’s observation and being able to interpret informa-
body knows the problem and is outpicturing it tion from that observation. With regard to the
in the tissues. sense of touch, someone said to me one day,
It is possible to create a more accurate “You feel from the heart, don’t you?” That is
diagnosis, one that is c!.oser to the true pattern right. You learn to feel into the heart of the
than either that of the patient’s opinion or the patient’s problem from a still-leverage point
physician’s opinion. We can utilize the infor- that allows the functions and dysfunctions of
mation, the facts, the know-how of the third the patient to be reflected back into your touch
problem, the patient’s body, to bring this and feel. The first step in developing this
diagnosis into existence. We can use the depth of feel and touch is to reevaluate the
interpretative skills of ourselves as physicians patient from the third problem standpoint,
as an integral part of this process. In addition, just what does the patient’s body want to tell
we can train our senses, .especially our sense you? Take the patient’s story and opinion and
of touch, to lead us into the structure-function set it aside, take your opinion and diagnosis
of the patient’s anatomical-physiological and set it aside, then let the patient’s body
mechanisms and make them give us the informa- give you its opinion. Place your hands and
tion we need. Needless to say, in invoking fingers on the patient in the area of his com-
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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION -- BECKER

plaint or complaints. Let the feel of the tissues Texas in the fall of 1961.
from the inner core of their depths come through Why a hurricane to describe potency?
your touch and read and “listen” to their story. Because the principles and manifestations of a
To get this story it is necessary to read function- hurricane can, in my opinion, be shown to be
structure in tissues. To do this we need to very similar in analogy to the principles and
know something about potency, which we will manifestations of disease and trauma within the
discuss now, and something about the fulcrum, human body. The eye of the hurricane carries
which we will discuss later. the potency or power for the whole storm, the
spirals of the high winds feeding into the eye
Potency manifest the destructiveness of the storm. The
eye of the hurricane carries the pattern for the
The knowledge of potency within tissues whole storm. Any change in the eye automati-
begins with a statement given to us by Dr. W. G. cally changes the spiralling effects of the winds
Sutherland who said, “Allowing the physiological feeding into the eye and thus the pattern of the
function within to manifest its own unerring po- storm. Witness the next hurricane that follow-
tency rather than the use of blind force from with- ed Carla. It was a hurricane that was spawned
out.” (1) This is a statement of the principle in the Atlantic and was approaching the New
upon which we will develop an understanding of England states. While still some distance from
what is potency. The diagnostic tool with which the land, the eye of the hurricane closed and
we will learn to read and understand this potency the hurricane was no longer a hurricane but just
is the principle of the use of the fulcrum. We another gale. So it is the presence of this eye
will use the principle of the fulcrum in applying that determines whether it is a hurricane or just
our hands and fingers so as to create a condition an ordinary storm. Within the eye is the po-
in which the principle of the potency may become tency “having authority or power” to create the
knowledge for our use in diagnosis and treatment. manifestations of the spiralling winds making
Webster’s dictionary defines potency as up the storm.
“the state or quality of being potent, or the Carla was born in the Caribbean Sea,
degree of this; power; strength”. (2) It defines south and east of the Yucatan Peninsula. As
potent as “able to control or influence: having she grew, she curved her way past the Yucatan
authority or power”. (3) We have heard for years Peninsula towards the coast of Texas. She
that the body has within itself all the factors developed an eye that was thirty miles in
with which to maintain health and to heal itself diameter and 30,000 to 40,000 feet in depth.
in case of disease or trauma. This statement Feeding into the low pressure area of the eye
is basically true. The body has the capacity were spirals of winds, travelling counter-
to express health through this inherent potency clockwise, a minimum of 600 miles in diameter.
and it has the capacity to maintain compensatory She travelled towards the coast at 12 to 15
mechanisms in response to trauma or disease knots per hour until she neared the land surface
through variant potencies. At the very core of where she met resistance and came to a halt off
total health there is a potency within the human the coast of Texas. She sat there for 12 to 18
body manifesting it in health. At the very core hours. The tremendous winds in her spirals
of every traumatic or disease condition within pounded the coast hour after hour with blinding
the human body is a potency manifesting its rain at 100 plus miles per hour intensity.
interrelationship with the body in trauma or Finally, she moved inland and the edge of the
disease. It is up to us to learn to feel this eye had winds clocked at a maximum of 173
potency. It is relatively easy to feel the miles per hour and heavy rain. Imagine being
tensions and stresses of trauma and disease as bombarded by rain drops travelling at that speed.
they are manifesting this pattern of trauma or As the eye touched the coast, the winds ceased
disease. But within these manifesting elements and all was still during the time that it took for
there is a potency that is “able to control or the 30 mile diameter of the eye to travel north-
influence: having authority or power”. It centers ward in its curved pathway. When the backside
the disturbance. It can be sensed and read by of the eye was reached, the winds again struck
a feeling touch. at better than 100 miles per hour from the
To bring the idea of what it means to feel opposite direction. To show the over all
potency within a given problem let us consider capacity of such a storm, while the winds were
something outside of ourselves and describe it 100 miles per hour at the coast, we in Dallas
to demonstrate the power within potency. Let were experiencing winds up to 30 to 40 miles
us consider the hurricane Carla which struck per hour from the east 400 miles north of the
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ACADEMY OF APPLIED OSTEOPATHY -- 1963 YEAR BQOK

coast. Not only were there high winds but after the passage of the eye. Men trained to
there were also other manifestations within the understand mechanisms of this type of storm
ends of the spirals. Tornados were being formed, can know the various factors within the storm
one of which went through the city of Galveston pattern by the interpretation of their own senses
after the eye of the hurricane had travelled a in addition to that information given to them by
considerable distance inland. As long as the the instruments they are watching. They know
hurricane travelled over the Caribbean Sea, the when they are in the eye or in the periphery of
winds around the eye increased in intensity due the spirals. They can feel it with their whole
to lack of anything to slow them up but when the being.
eye continued inland the surface of the continent Thus it seems logical to me that the
began slowing down the intensity of the wind. physician can train his touch to recognize and
By the time the eye reached Fort Worth the winds accept the fact that within every trauma or
had reduced to 60 miles per hour on the front disease pattern there is an “eye” within or
edge of the eye, then a period of stillness during without his patient, which has within it a
the passage of the eye and again 60 miles per potency to manifest this traumatic or disease
hour winds from the opposite direction on the condition. It is a point of stillness within that
backside of the eye. Finally, Carla continued focus. It is invisible, to be sure, but it can be
her way north into Oklahoma and Kansas and was perceived by the trained discerning touch of the
dissipated by the land over which she travelled physician. How do I know? I have been aware
until her eye no longer had enough energy in it of this potency hundreds of times. This is
to maintain her identity. something that has to be learned by personal
Millions of dollars of property damage due experience. It was forced upon me by learning
to flooding, high tides, rain, strong winds, and to read structure-function within the patients
tornados were the result of this one storm. who brought their problems to me. I became
Practically no lives were lost due to excellent aware of this area of stillness centering the
communication systems. 500,000 people evacu- trauma or disease. Slowly over a long period
ated the coastal area in advance of the storm of time, knowledge and understanding came as
proper. Those who did stay more or less on the to why it existed and its part in the traumatic or
fringe of the storm center were able to watch disease picture. I observed through the years
the eye of Carla on their television screens that when any change took place in the area of
through the radar readings that were being taken stillness there was manifest a whole new change
at the time of the storm. Modern instrumentation in the trauma or disease pattern. Like the eye
and communication have given us a very complete of the hurricane that closed in the storm off the
picture of Carla. Tiros, one of the satellites New England coast, it was no longer a hurricane.
going around the earth in its orbits, sent down If any change had taken place in the eye of
pictures of the eye and of the huge spirals of Carla before she hit the Texas coastline, her
winds feeding into the eye. Hurricane hunters entire pattern of spirals, the intensity of her
flying B-29s flew into the storm and into the winds and other factors would have modified
eye itself and registered dozens of different to meet the change in the potency within the
data concerning her and plotted her course from eye : Thus I slowly learned to add this diagnostic
early in her existence in the Caribbean. Radar insight to my armamentarium until it has become
readings followed her progress. Radio, tele- a day to day experience with every new patient
vision and news copy kept up with her through- as well as with those I am seeing over a period
out. of time. It was by deliberately taking the
This brief description, then, brings us patient’s opinion and setting it aside, taking my
the story of Carla, a hurricane, While those diagnosis and setting it aside, and going to the
of US who sat on the sidelines were able to structure-function of the anatomical-physiologi-
watch the growth, the development, and progress cal mechanisms of the patient’s body that I was
of Carla’s existence, those scientists who flew able to acquire this knowledge. This is not
in the B-29s were able to literally know and something that I have discovered. It exists of
and experience the high winds in the spirals and itself. It merely asks acceptance of its existence
the potency of the eye of the hurricane. It was and time to develop a sense of touch and aware-
a physical awareness to them. It was an aware- ness with which to perceive it. The problem
ness to those who were in the direct path of the remains, as always, how to find words to
eye as it crossed the state of Texas, first the express that which it is and methods whereby it
winds, then the stillness of the eye, then the may become part of one’s experience. It is a
following winds from the opposite direction self-taught process.
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Fulcrum that the fingers can mold themselves to the


patient’s body. It is a gentle contact yet one
To develop this sense of touch it is with firmness and authority. To borrow a
necessary to learn the principle of the fulcrum descriptive analysis from Dr. Sutherland, “It
and then to develop a method of using the fulcrum is necessary to develop fingers with brain cells
in the diagnostic approach to these problems. in their tips, fingers capable of feeling
Webster defines a fulcrum as “the support or thinking, seeing. Therefore first instruct the
point of support on which a lever turns in rais- fingers how to feel, how to think, how to see,
ing or moving something; “hence, a means of and then let them touch. There must be a
exerting influence, pressure, etc. (4) Dr. W. G. ‘finger-feel’, a ‘finger-thought’, a ‘finger-
G. Sutherland in describing the fulcrum in sight”’ (5) with which to read the functions and
relationship to the two halves of the tentorium dysfunctions of the body. The mechanisms of
cerebelli and falx cerebri stated, “The Fulcrum the body and their potencies are always in
(the junction of the falx cerebri and tentqrium action and can be felt with a thinking, feeling,
cerebelli at the straight sinus) is the still- seeing touch that in time becomes a knowing
leverage junction over and through which the touch. It is like getting onto a moving train.
three sickles function physiologically in the The train continues in motion and action as I
maintenance of balance in the cranial membran- get on it, analyze the roughness of the road
eous articular mechanism. Like all fulcrums, bed, the side sway around the curves, its
it may be shifted from point to point, yet relative speed, and then get off the train
remaining still in its leverage functioning.” while it continues in action. So it is with the
The key to understanding the principle of a problems within the patient. I move in on a
fulcrum is to realize that it is a still-leverage living mechanism that continues to function, I
junction, yet it may be shifted from point to make my diagnosis, administer my treatment,
point while remaining still in its leverage and leave the mechanisms continuing their ever
functioning. changing patterns. My touch is think-deep,
On a gross level of functioning the see-deep, feel-deep and yet does not limit or
scientists on the B-29s were relatively still lock the structure-function of the tissues I am
points, riding in a plane that was responding examining.
to the storm into which they were flying. The I can go another step in developing my
scientists’ whole bodies reflected the move- touch, Through the still-point at the fulcrum
ments of the storm and the potency or stillness and the depths of my finger-touch, I can develop
of the eye of the hurricane. This was something knowledgeable awareness of potency and
they could feel during the flight, could report, structure-function in tissues within the patient's
and interpret. The physician must bring this body. This awareness goes beyond the physical
principle down to a much finer degree of use sensations of the physician’s five senses. This
than that of the whole body. He must set up a is not what I feel with my finger-touch. That
still-leverage mechanism with which he can would be my opinion. Instead this is what the
feel the stress and tension in the tissues under patient’s body is reporting through my fulcrum
his hands and fingers and find the potency or and finger-touch. This is awareness. This is
area of stillness within that area of stress. He a “listening” finger-touch. This is the patient’s
does this by placing his hand or hands near the body’s opinion. This is knowledge gained from
area in which the patient is experiencing the patient’s body, not mere information.
difficulties and then establishes a fulcrum with I can control the gentle yet firm contact of
his elbow, his forearm, his crossed fingers, or my hands and fingers by the manner in which I
any other part of him that is convenient to his establish a fulcrum from which I will develop
comfort. From this fulcrum, his fingers become this touch. Establish a fulcrum to provide a
the end of a lever that can note the changes working point from which to operate and evaluate
taking place within the body. His fulcrum the case and yet let it be free enough to allow it
point can be shifted from time to time to adapt to shift, while maintaining still-leverage
to changes within the body, yet remaining functioning, to adapt to the changing needs from
still in its leverage functioning. within the mechanisms under examination. Try
examining a hyperactive child and you will see
Touch the need for a shifting fulcrum and hand-finger
lever, not only within the child’s mechanisms
In placing the hands and fingers on the but also for the child itself. The hand and
tissues under examination, do so with the idea finger contact can be light and gentle, yet it
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ACADEMY OF APPLIED OSTEOPATHY -- 1963 YEAR BOOK

can be observed that increasing the amount of within the anatomical-physiological units.
pressure at the fulcrum automatically increases Another example would be a sick liver in
the depth of palpatory touch at the end of the a case of hepatitis. With the patient supine,
lever, the hand and fingers; decreasing the the physician can sit comfortably beside the
pressure automatically decreases the depth of patient, place one hand under the lower rib
palpatory touch at the end of the lever. Thus cage on the right side beneath the liver. Then
with knowing fingers and the use of the fulcrum he can place the elbow or forearm of that hand
I become aware of potency within my patient. on his own knee. Thus he has his fulcrum
Thus I can modify my touch to meet the various point on his knee or thigh and his examining
needs of the kinetic energies expressed by the fingers under the sick organ. The other hand
manifesting anatomical-physiological mechanisms can be placed on the rib cage above the liver
and their potencies. Every patient is different and the elbow or forearm placed on some point
and each patient is different each time he comes that is comfortable to maintain its contact.
in for attention. The work continuously builds Thus he will have the sick organ between his
the physician’s fund of knowledge and insight. examining hands. By reading from these double
For example, a patient comes in with a fulcrums, he will be able to note structure-
low back problem. With the patient supine upon function changes taking place within the area
the table, it is possible for the physician to sit of the liver. He will be able to sense whether
beside the patient and to place his hand under the liver is moving or functioning upon its
the sacrum with the finger tips extended upward falciform ligament as it is supposed to do in
so their contacts are on the lower back. By health. He will be able to sense whether it
leaning comfortably on his elbow, the physician responds to rhythmic up and down movements of
establishes a fulcrum from which to read the the diaphragm during respiratory inhalation and
changes taking place in the back. The patient exhalation as it is supposed to do in health.
may flex his knees with his feet on the table, He will be able to allow the area of stillness,
if it is more comfortable for him to do so. The the potency for this particular problem to come
physician’s other hand can be brought from the to a focus. He will learn a great deal about
side and placed under the lower back. The this sick liver with time and repeated examina-
fulcrum for this contact can be the edge of the tions on subsequent calls. As the liver as an
table against the forearm or the elbow on the anatomical-physiological unit regains its
physician’s knee. By applying a modest capacity to respond to respiratory changes of
increase of pressure at the fulcrum to cause a the diaphragm, its normal movements in relation-
slight degree of compression through the sacrum ship to the falciform ligament, and its venous
towards the head, he will initiate the kinetic and lymphatic drainage to begin to open and
energy that will allow the structure-function of function, he will know that this is a case of
the stress area to begin its pattern to be re- hepatitis that has reversed its pathological
flected back to his touch. He learns to read state and is returning to normal. All of these
these changes from the fulcrum point that he changes are perceptible to the discerning touch
establishes at the elbow, or from both fulcrum from the fulcrums he establishes to examine
points, if he is using more than one contact. this organ.
He will feel the pull and tug of the tissues deep
within them, he will feel the patterns of mobility Application
and motility, and he will become conscious of
the fact that there is a quiet point, a still-point, The application of the principle of the
an area of stillness within the stress pattern. fulcrum is as varied as the list of complaints
This is the point of potency for that particular that walk into the physician’s office. Each
strain. This is the point at which the stress case calls for its own application. The patterns
pattern is maintaining its focus to be a stress of setting up a fulcrum or fulcrums from which
pattern. I am not talking about the anatomical- the examining fingers can study the problem are
physiological units of tissues. I am talking an individual development each physician must
about the kinetics of the energy fields that make for himself. The physician must know
make up this stress pattern. The anatomical- anatomy and physiology and as much function-
physiological tissue units are manifesting this structure that accompanies anatomical-physio-
kinetic energy and are expressing this dysfunction logical units as is possible. With the develop-
as tissue changes and symptoms. Any change ment of this type of touch through fulcrum points
within the kinetics of the energy field of the into and through the structure-function patterns
potency will change the pattern of functioning manifesting their changes under his hands, this
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DIAGNOSTIC TOUCH: ITS PRINCIPLES AND APPLICATION -- BECKER

knowledge becomes an ever-increasing degree body and as such can be used by the understand-
of understanding. It opens the door as to why ing physician to determine function-structure
this patient is experiencing the complaints he within the anatomical-physiological units of the
expresses. Many times the laboratory tests body. What is this potency? No one knows.
fail to reveal the source of the complaints but Nor is it necessary to know, anymore than the
his trained touch will bring him this understanding engineer has to know what electricity is before
Why is it necessary to establish these he puts it to use. The physician can learn to
fulcrum points? The physician is attempting to recognize this potency, accept its presence, and
feel function within living tissues and to find use it for diagnosis and treatment. As was said
the still-point from which this pattern of stress early in this paper, at the very core of total
is manifesting its symptoms. He has to estab- health there is a potency within the human body
lish a still-point with which to be aware of the manifesting itself in health. At the very core of
still-point within the tissues. As was said every traumatic or disease condition within the
earlier, he feels from the heart of his still- human body is a potency manifesting its inter-
point into the heart of the still-point within the relationship with the body in trauma and disease.
patient. It is necessary to become aware of and use this
When is this type of trained touch appli- potency. Within it is the key to reverse the
cable and to what kind of cases does it apply? pathology that is present and to allow the basic
There is no limit to its application. It is a tool potency that is health to remanifest itself.
that has some form of use for practically every This paper is a statement of principles
type of complaint that comes to our attention. and methods whereby to apply those principles
It will distinguish the difference between the in the diagnosis of health, disease and trauma.
congestive headache and the vasospastic type It is not a paper to describe manipulative pro-
of headache. It will locate the specific sinus cedures. The power and authority inherent
that is chronically or acutely filled with mater- within the potencies and the structure-function-
ial. It will localize the specific lobe of the ing of the anatomical-physiological mechanisms
lung that is sick in lobar pneumonia. It will provide the motive kinetic energy with which to
locate the strains and stresses of the musculo- diagnose and modify the problems we find in our
skeletal system. It has uses from the top of patients. We establish our contacts and utilize
the head to the soles of the feet. It is a that which is built into the tissues themselves.
diagnostic tool that is added to the routine However, a point to consider for those of us who
examination of the patient along with the do use manipulative procedures is that if we add
laboratory findings. It will add insight as to the principle of the fulcrum to our manipulative
the chronicity of the case, the present status procedures we will be making those applications
of the case, and the possible prognosis for much more efficient. After we have introduced
the case. the leverage we may be using in the manipulation
Another analogy might be of interest at pause a moment, establish a fulcrum, pause
this point. The skilled electrical engineer is again and let the thinking, feeling, seeing
able to apply his art and science because he fingers interpret the degree of leverage and the
accepts the fact that electrical energy is pre- amount of force we need to use to complete the
sent in his machinery. He takes his wires, his procedure. We will find that we need less ap-
transistors, his printed circuits, his vacuum plication of force from without and that we will
tubes and strings these things together to pro- be able to control that leverage with much great-
duce radios, radar equipment, television sets, er precision.
and electrical circuits for home and business. Let it be remembered, though, that it is
He knows that the energy for these is electrical possible to utilize that which is already built
in nature and puts it to use. He does not know into the problems we find in our patients. We
what electricity is itself but he can use it to merely have to contact it and let it do the work
develop functioning mechanisms. Electricity, for us. Using the principle of the fulcrum and
too, is invisible but it can be measured and the kinetic energies of the anatomical-physiolo-
felt, instrument-wise and sense-wise. gical mechanisms with their potencies will re-
The physician has available to him a form solve and reverse the pathological dysfunctioning
of energy within the living body which has been towards the normal health of the individual.
called the potency in this paper. It is not in- The question has been asked me as to the
tended to call it electricity in the sense that it amount of time it takes to use this approach.
corresponds to the electrical energy the engineer This is not a time consuming process. Because
uses. It is a form of energy that is in the living we are using mechanisms already in action, it
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ACADEMY OF APPLIED OSTEOPATHY -- 1963 YEAR BOOK

is only necessary to contact them and let them calls will add more insight until he is able to
speak for themselves. It is possible to make ‘a use his knowledge to understand the past history
diagnosis in less than ten minutes. The average of the dysfunction, its present status, and pro-
patient that comes in with a problem does not ject a prognosis for its eventual outcome. Old
require that he be minutely examined from head strains feel like old strains and can be dated as
to toe. He comes in with a complaint in a being weeks, months, or years old. As they
specific area. It is possible to go to that area modify their patterns, there is a point at which
and make an examination that will give the the physician knows that this pattern or patterns
information you need to explain to him why he is has reversed its hold upon the patient and that
having his difficulties. Of course, this may be it will be a matter of days, weeks or months
only a small portion of the interrelated total until a good resolution will have been accomplish-
picture of his problem but it is a beginning from ed. New strains feel like new strains. Their
which to go to other areas and finally to bring time-clock can be correspondingly charted. The
the complete diagnosis into focus. Herein is same applies in disease conditions. It is pro-
where the physician’s knowledge of anatomy and ductive work. There is something new to be
physiology plays an important role. He is able learned each time you apply it. It is also work
to correlate his knowledge with his sense of that opens many doors for better understanding
touch and to trace the pattern of the disability only to discover that opening those doors
and dysfunctioning until the whole diagnosis is exposes more doors to open.
clarified in his thinking. Subsequent office

REFERENCES:
(1) Sutherland, W. G., Preface to Reprint Edition of THE CRANIAL BOWL issued by the
Osteopathic Cranial Association.
(2) Webster’s New World Dictionary, College Edition; 1960; pg. 1143
(3) Webster’s New World Dictionary, College Edition: 1960; pg. 1143
(4) Webster’s New World Dictionary, College Edition; 1960; pg. 585
(5) Sutherland, W. G., “Let’s Be Up and Touching”, The Osteopathic Physician; 1914

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