by Michael Kern
Inviolable wisdom
The subtle rhythms produced by the Breath of Life are the primary self-regulating and self-healing forces in the body. Dr. Sutherland described that the potency of the Breath of Life carries an inviolable and unadulterated wisdom, beyond the relatively meagre intelligence of our own human ideas and concepts.59 This potency carries our original matrix of health. Therefore the balanced expression of primary respiration ensures a constant distribution of inherent health to all cells of the body. In the words of Dr. Rollin Becker,
It provides the physiological evidence of health within the whole body physiology as well as evidence of less than health for any area of dysfunction. It can be used as a diagnostic tool as well as being a tool for treatment, and it is a manifestation of life within the patient that the physician can use in his service to restore health to the patient.60
3
THE PRIMARY RESPIRATORY MECHANISM
Know your anatomy and your physiology, but
when you get your hands on a patient’s body,
never forget that a living soul dwells therein.
DR. A.T. STILL
PRIMARY RESPIRATORY MOTION
The rhythmic, involuntary mobility of the tissues and fluids and the various tides are all totally integrated with each other and with the body as a unit.1
DR. ROLLIN BECKER
One thing that becomes clear when considering the physiological functioning of the body is the remarkable order that underlies its complexity. The systems of the body are guided by a wisdom that is actually a manifestation of our own basic nature. This inherent, intelligent force of integration and wholeness makes itself available through the rhythms of the Breath of Life.
In this chapter we will take a look at the key tissue and fluid systems located at the core of the body that express primary respiration. We will also look at the significance of these tissues and fluids for the totality of our health and the particular ways that they rhythmically move.
In order to get a sense of how the structures at the core of the body function, it is necessary to have an understanding of their anatomy. Therefore, a review of major anatomical features is also included here.
Tensile motion
All the bones, membranes, fluids and organs of the body express primary respiration as specific patterns of movement. At the level of the cranial rhythmic impulse (C.R.I.), individual tissues move like wave-forms that ride on deeper tidal forces.2 By comparison, the slower mid-tide is expressed in the fluids, and consequently in all living tissues, of the body as a dynamic and unified field of motion.3
The cyclical rhythms of primary respiration have the characteristic of reciprocal tension, a kind of tensile pushing and pulling produced in the body. This is expressed first as a movement one way, and then as a movement back. At the level of the C.R.I. these tissue and fluid rhythms function at the average rate of between eight to twelve cycles per minute. This may be palpated as a slight rocking of individual structures. It is also sometimes called the craniosacral rhythm, or abbreviated to the cranial rhythm. At the level of the mid-tide, an underlying reciprocal tension motion is expressed as a push and pull within the unified field of tissues, fluids and potency at the rate of about two-and-a-half cycles per minute.
Mobility and motility
All parts of the body expresses primary respiration as both mobility and motility. Mobility refers to the movement of one structure in relationship to another, for example at a joint or suture, or between different organs. Each structure in the body expresses a particular natural pattern of craniosacral mobility. This kind of motion occurs solely as a function of the C.R.I.
Motility refers to the inner breathing of tissues, a motion that arises from within a particular structure. Motility occurs as the direct expression of the potency of the Breath of Life, which motivates and enlivens tissues from the inside. Motility is normally expressed in tissues as a welling up and expansion from side to side, followed by a receding and narrowing. It is essentially a factor of the mid-tide.
It is thought that the natural craniosacral mobility occurring between structures is primarily generated by their intrinsic motility.
Primary respiratory mechanism
After Dr. Sutherland discovered the existence of motion involving the cranial bones, he embarked on a path of enquiry which led him to dig deeper for further understanding.4 He realized that there is a system of inter-related tissues and fluids at the core of the body, all of which play an important role in expressing primary respiration. These are the tissues and fluids in and around the dural membrane system, a continuous tissue infrastructure that surrounds the brain and spinal cord.
This inter-connecting system is referred to as the primary respiratory mechanism (see Figure 1.2). It comprises the cerebrospinal fluid, the central nervous system, the membranes that surround the central nervous system, the cranial bones and the sacrum. These five core components are also sometimes called the craniosacral system. The physiological motion of these tissues and fluids has important consequences for the whole body; many pathologies can be traced back to some disturbance in their function.
In health, all aspects of the primary respiratory mechanism operate in a harmonic relationship. Each component expresses primary respiration in a specific way, but they function together as part of an integrated system.
The different aspects of the primary respiratory mechanism can be compared to the different instruments in an orchestra, which all play the same music but contribute in different ways to the overall sound. In this analogy, the Breath of Life can be seen as the conductor of the symphony and our embryological blueprint as the composer.
Two phases
Primary respiration is rhythmically expressed in two phases. However, these two phases are described in different ways, according to which parts of the body are being referred. The terms inhalation and exhalation are usually used to describe the motion of the cerebrospinal fluid (C.S.F.) and the central nervous system. These rise and widen from side to side during the inhalation phase, and descend and narrow from side to side during the exhalation phase.
Other parts of the body express primary respiration in phases that are traditionally described as:
flexion and extension
external and internal rotation.
Flexion and extension refer to the motion of single midline structures. One example of such a midline structure is the occipital bone, centrally placed at the back of the head (see Figure 3.13).
External and internal rotation refer to the motion of all paired structures of the body. The two parietal bones capping the top of the head, one on the left and one on the right, are examples of paired structures (see Figure 3.1).
Flexion of the midline structures and external rotation of the paired structures occur simultaneously during the inhalation phase of primary respiration. For example, while the central nervous system and C.S.F. are expressing inhalation, the occipital bone moves into flexion and the parietal bones move into external rotation. Extension and internal rotation occur simultaneously during the exhalation phase.
To summarize, the primary respiration of different parts of the body is described as:
Figure 3.1: External and internal rotation of the parietal bones (illustration credit 3.1)
At the level of the mid-tide and long tide (i.e., deeper organizing forces), the same patterns of motion may be perceived, but as subtle field phenomena rather than as movements of individual structures. Therefore, in biodynamic craniosacral practice, where an emphasis is placed on working with these deeper tides, all the above terms are often simplified to just inhalation and exhalation. These terms describe the essential movements of tissues and fluids as they discreetly breathe in and breathe out during the two phases of primary respiration.
FIVE CORE ASPECTS
The primary respiratory mechanism has been broken down into five components for teaching purposes, but it remains one unit of function.5
DR. ROLLIN BECKER
In this section we will explore the tissue and fluid systems that constitute the core elements of the primary respiratory mechanism. These pages contain quite a lot of information about some specific ways that the Breath of Life is expressed in the body. Remember that the organization of our anatomy reflects the functioning of the whole of ourselves—mind, body and spirit. To help bring this information alive, see if you can relate these descriptions to the movements and sensations in your own body. The corresponding diagrams may help you picture clearly what I am writing about. If you are unfamiliar with some of the anatomical terms that are used, the glossary at the back of the book may help.
The five principal aspects that constitute the primary respiratory mechanism play an important role in expressing the Breath of Life and regulating the balance of health. Although these tissues have great significance, primary respiration is actually a feature of the whole body. Therefore, we will also consider how the body as a whole acts as an integrated unit of function, as well as the way that rhythmic motion is expressed by all fluids, connective tissues, bones, organs and muscles.
The five components at the core of the primary respiratory mechanism are:
The inherent fluctuation of cerebrospinal fluid (C.S.F.)
The inherent motility of the central nervous system
The mobility of the reciprocal tension membranes
The motion of cranial bones
The involuntary motion of the sacrum between the iliac bones of the pelvis.
1) The Inherent Fluctuation of Cerebrospinal Fluid
The inherent fluctuation of cerebrospinal fluid (C.S.F.) refers to its tide-like motion along the body, contained within the membranes that surround the central nervous system.
C.S.F. is a transparent, slightly yellowish fluid, produced by a process of filtration and secretion. This occurs within specialized tissues called choroid plexi (see Figure 3.2). These are cauliflower-shaped growths of blood vessels located in the fluid-filled cavities of the brain, the ventricles. The choroid plexi filter blood entering the brain, adding certain substances such as magnesium and chloride, while potassium and calcium are removed.6 The choroid plexi also filter any harmful materials that may be carried in the blood. Therefore, C.S.F. has a different chemical composition from blood, distinctly suited to maintain the delicate balance of the central nervous system, which it bathes. Approximately 150 ml of C.S.F. is contained in the cavities of the brain and spinal canal at any one time, and its total volume is replaced (i.e., produced and reabsorbed) every three to four hours.
Figure 3.2: Circulation of cerebrospinal fluid (illustration credit 3.2)
Circulation of C.S.F.
C.S.F. circulates around the central nervous system, before being reabsorbed back into the bloodstream. This reabsorption occurs through small projections—the arachnoid villi—which are located in the head’s drainage channels called venous sinuses (see Figures 3.2, and 3.10). The system of venous sinuses in the head connects with veins, which then transport the reabsorbed C.S.F. back to the heart along with de-oxygenated blood. However, radioactive tagging has also indicated that small amounts of C.S.F. escape from the spinal column through sheaths of connective tissue that surround the spinal nerves (see Figure 3.19).7 The hollow collagen fibres within these connective tissues provide the medium through which C.S.F. can pass into the rest of the body.
Physiology of C.S.F.
C.S.F. provides essential nourishment for the central nervous system, helping it to maintain a consistent chemical balance, even when other conditions of the body are changing. All the critical functions that are mediated by the central nervous system are dependent upon the supply of this fluid. If the physiology of C.S.F. is disturbed, the functioning of the central nervous system can be affected, with vast ramifications for the health of the whole body.
Over 100 years ago, Dr. A.T. Still, the visionary founder of osteopathy, paid particular attention to the properties of C.S.F. He wrote,
Cerebrospinal fluid is the highest known element that is contained in the human body and unless the brain furnishes this fluid in abundance a disabled condition of the body will remain. He who is able to reason will see that this great river of life must be tapped and the withering fields irrigated at once or the harvest of health be forever lost.8
It is known that the nervous system degenerates if the choroid plexi (which produce C.S.F.) are removed.9 Furthermore, there is also evidence that the choroid plexi may deteriorate in the elderly. This suggests that certain types of brain disorders, such as Alzheimer’s disease, may be caused by an inadequate C.S.F. production.10 Any deficiency in the production of C.S.F. will lead to malnutrition of the brain.
C.S.F. has a number of other crucial roles to play. Waste products are rinsed from the central nervous system by the steady flow and reabsorption of C.S.F. It provides “water beds” for the protection of the brain, acting as a shock absorber and helping to maintain the shape of the brain.11 C.S.F. also dampens the physical effects that the pulsation of arteries can have on the sensitive structures of the central nervous system.
If all the vital physiological functions of C.S.F. are considered, the importance of encouraging its proper flow can be appreciated. There is much truth in the statement made by Dr. Harold Magoun when he called C.S.F. “a regulatory complex which transcends any and all other agencies throughout the body.”12
Inherent fluctuation
In addition to its circulation around the central nervous system, C.S.F. also has a tidal motion—described as an inherent fluctuation. The fluctuation is called “inherent” because it moves due to a power found within itself, not because of any external agency. The tidal fluctuation of C.S.F. is a motion that ebbs and flows along the body in rhythmic cycles. Like the ocean tides this is a movement of the whole volume of fluid at the same time, rather than a current, a circulation, or a wave.
In many ways, the body displays similar properties to the planet on which we live. Dr. Sutherland not only compared the rhythmic fluctuation of C.S.F. to the tide of the ocean, but also concluded that it is governed by the same great intelligence which governs the ocean tide, the rotation of the earth and the motion of all the planets.13 In Chinese medicine our connection to the natural world is well recognized. According to the Chinese system, C.S.F. is controlled by “kidney energy” and the kidneys are governed by the moon. Therefore the moon, which governs the tides of the oceans, also governs the functioning of C.S.F. within the body.
The tidal motion of C.S.F. is also described as a longitudinal fluctuation because it moves up and down along the length of the body. As we noted there are two phases to this motion, described as inhalation and exhalation. C.S.F. rises up the body in inhalation and recedes down the body in exhalation. In inhalation there is also a welling up of fluid from side to side and a narrowing from front to back. In exhalation there is a side-to-side narrowing of the fluid.
Whereas the ocean tide rolls onto the seashore twice a day, the fluctuating motion of C.S.F. in the body occurs at faster rates, on average about ten times each minute with the cranial rhythmic impulse and about two-and-a-half times a minute at the level of the mid-tide.14 If it seems hard to picture these simultaneous tidal rates, remember that the rhythms generated by the Breath of Life coexist as motions enfolded within each other. We are polyrhythmic systems.
Pressurestat mechanism
Over the years a number of theories have attempted to explain how the longitudinal fluctuation of C.S.F. is initiated. This section contains an outline of some of these theories, although none have been proven.
Some practitioners have suggested that this motion is generated by movements in the central nervous system.15 Dr. John Upledger proposes that it occurs because of the way C.S.F. is produced and reabsorbed. He describes a rhythmic build-up of C.S.F. controlled by a pressurestat mechanism. In this model, the membrane sac within which C.S.F. circulates is seen as a semi-enclosed hydraulic system. Pressure is maintained in this system because it co
ntains only partial openings through which C.S.F. is produced and reabsorbed.
Dr. Upledger proposes that C.S.F. production at the choroid plexi is pulsatile.16 He suggests that normally production goes on for about three seconds, then stops for about three seconds, and then repeats. He also suggests that reabsorption through the arachnoid villi is constant. In this way, an expansive rhythm is produced about every six seconds, or ten cycles per minute. Dr. Upledger surmises that there are sensitive nerve reflexes that are located in the sagittal suture between the two parietal bones at the top of the skull. As the hydraulic system fills with C.S.F., these nerve reflexes get stretched and send messages to the choroid plexi to stop producing C.S.F.
Ball valve mechanism
It has also been proposed that a ball valve mechanism may control the drainage of C.S.F.17 The straight sinus is one of the main channels in the venous sinus system, helping to drain reabsorbed C.S.F. away from the head (see Figure 3.2). A bundle of tissue composed of arachnoid villi has been identified at the entrance to this channel. It is thought that this tissue can become engorged with blood in rhythmic cycles, thus intermittently blocking the passage of fluid through the straight sinus. This mechanism may help to control the outflow of fluid from the head and rhythmically increase the pressure of C.S.F. within the system. This pressure increase may then affect the production of C.S.F. at the choroid plexi, which temporarily shuts off as a result. When the ball valve mechanism unblocks the straight sinus, pressure is reduced and C.S.F. production resumes.