What follows will be a bit of a mental meandering (maybe). I have come across many questions and discussions about what Osteopathy actually is. Common questions are formed as “what is the difference between Osteopathy and (name a hands on practice here)?” I don’t always have a good answer. The reality is that I know what Osteopathy IS while I may not know what other professions are exactly as I am not trained in them or an expert on them. One of the statements I seem to stumble across is that Osteopathy is based on the statement that “the rule of the artery is supreme” which comes from Dr. Still’s writings which are available in many forms and can be found online if anyone wanted to do a bit of searching. Anyone that picks up Dr. Still’s books and actually pays attention to what he put down will know that he said almost everything was of the utmost importance (fascia as the hunting ground for disease).
Before I move on, I will make it clear why I am writing any of this: I want to put in my two cents as to WHY people seem to think Osteopathy is obsessed with arteries and why that thought is likely missing the point.
What is an artery? On a basic level they are blood vessels that carry oxygenated and nutrient dense blood to the body away from the heart. If the story stopped there then it would follow that Osteopaths would just try to dump oxygen and nutrients in to the blood however the heck they could through needles, food, supplements, oxygen saturation devices, changes of location to higher or lower altitudes, and so on. The story does not end (or even begin) there. It must be known how and (at least where) that arterial blood was created in the composition in which it should be ideally found. This means that the Operator will need to understand all of the inputs to the system which will include the central, peripheral, autonomic, and enteric nervous systems, the filtering organs (spleen, liver, and kidneys), the nutrient absorbing organs (stomach, duodenum, jejunum, ileum), the blood pressure regulation systems (urethra, bladder, ureters, kidneys, liver, lungs, heart, carotid body and sinus, medulla, and all of the circulatory vessels), and on infinitely.
It would seem to be fair to say that the arterial system is not as simple as arteries, arterioles, and capillaries. The circulatory system is not as simple as arteries and veins with all of the little bits between them.
So what the heck might the big deal about the arterial system be? Why would that be seen as the specialty of the Osteopath? If one has at least a cursory knowledge of physiology it may be said that health is the realm of arterial blood. What does that mean? The materials that build tissues, that regulate functions, that deliver immune responses through hormones or cells with immune functions are all located on the arterial side of circulation. The exhaust system is the venous and lymphatic vessels as they pass used fluid through filtering organs, out through the excretory channels, and eventually to the lungs for final gas exchange. If the cleanup systems are not functioning properly the arterial blood will not have the opportunity to be healthy.
Let us take one more step through this thought process. How the heck would the Osteopath possibly be able to treat the arterial system in any way with their hands? With an understanding of the functional relationships of all anatomy and the physiological relationships that exist within and between anatomy it is possible to create an optimal functional anatomical-physiological terrain to allow a person to express their fullest capacity to build and maintain health. That is the whole point of all of it. THE OSTEOPATH IS LOOKING TO BUILD THE HEALTH OF A PATIENT SO THAT THEY MAY USE THEIR OWN CAPACITY TO COMBAT DISEASE (as they are BUILT to do). Is it possible to actually directly touch an artery with your hands? Not directly. It is possible to understand the processes of nature, anatomy, physiology, physics, engineering, and philosophy to put them all together and touch the body that the artery lives in so that there is freedom for all of the structures inside the body as it lives in the environment where it is present.
The Osteopath may very well focus on the job of the artery in an intellectual sense, however that is not the only thing that is being considered. The fullest possible accounting of the patient is considered, a treatment is applied based on the principles of nature as expressed in anatomy and physiology, and then health is monitored.
Attempting to truly understand how the body works seems to be something that, at the moment at least, is beyond the full grasp of any person I have encountered (myself especially). That said, it does seem very approachable to understand each piece of the body in isolation and then layer in the relationships with the rest of the body as needed to get the job done or to at least figure out what might be going on.
Here is where my two cents finally get pitched in to the pot. It is my current view that Dr. Still saw the power of finding the health of the patient (he said it directly) and the clearest place to think about health is the workings of the artery as it contains the health building materials and communicates them to all parts of the body. All substrate in some way or another is carried in arterial blood. It is the one thing that passes all tissues from an intellectual central point (the heart). If it is the job of the Osteopath to find and build health so that disease may be overcome by the patient through their inherent physiology then it would make sense to verbalize a grand statement such as “the rule of the artery is supreme”. Any part of the human body that does not do its job properly will fairly directly show up as a deviation from health in arterial blood. The only way to possibly create healthy blood is to ensure that all inputs are working properly. That is to say the treatment for healthy arterial blood is to treat the things that make it and NOT IN ISOLATION. It is not intelligent to treat a liver as just a liver. It is intelligent to consider the bones, muscles, ligaments, nerves, arteries, veins, and lymphatics that may directly and secondarily affect the liver and then make sure they are all doing their job properly or else any treatment to the liver will be a party trick at best.
All of the previous rambling considered, I will make a statement that comes from my experiences so far and that I will reconsider and alter going forward if I find information that compels me to change my view. Consider the rule of the artery supreme by understanding how clean arterial blood is made and remember, with no illusion, that the inputs to the arterial blood are where the answer lives, not absolutely in the artery itself.