The Cranial Letter ©

The Osteopathic Cranial Academy, Inc.

A Component Society of the American Academy of Osteopathy
Volume 69, Number 4
November 2016

2017 Annual Conference

The Legacy of Anne Wales: Passing Osteopathy Hand to Hand
June 15-18, 2017
Hyatt Regency Nicollet Mall, Minneapolis, Minnesota

The Cranial Letter
Official Newsletter of
The Osteopathic Cranial Academy
3535 E. 96th Street, Suite 101
Indianapolis, IN 46240
(317) 581-0411
FAX: (317) 580-9299
Email: info@cranialacademy.org
www.cranialacademy.org
Officers and Directors
Daniel A. Shadoan DO
President
James W. Binkerd DO
President-Elect
Junella T. Chin DO
Treasurer
R. Mitchell Hiserote DO
Secretary
Zinaida Pelkey DO FCA
Immediate Past President
Ali M. Carine DO
Theresa A. Cyr DO
Andrew M. Goldman DO
Annette Hulse DO
Thomas A. Moorcroft DO
Mark E. Rosen DO FCA
Matthew A. Gilmartin MD
(MD Associates Advisor)
Richard J. Joachim DDS
(DDS Associates Advisor)
Daniel Ronsmans DO
(International Affiliate Advisor)
Randall Davis DO
(Physician in Training Advisor)
Publication Schedule
February, May, August, November
Editorial/Advertising Deadline:
Four weeks prior to month of
publication
Managing Editor
Sidney N. Dunn
The Cranial Letter is published four times
annually by The Osteopathic Cranial
Academy as a member service.
Statements, opinions and advertising
expressed by contributors are those of
the authors and not necessarily those of
The Osteopathic Cranial Academy.
Publication of an article does not assume
responsibility for statements therein, nor
does printing an advertisement endorse a
product or service.
2 The Cranial Letter, November 2016, Volume 69, Number 4
Musings from the Executive Director
The 70th Anniversary Conference of the Osteopathic
Cranial Academy (OCA) will be held at the Hyatt Regency
Nicollet Mall in Minneapolis, MN, June 15-18, 2017. From
humble beginnings almost 70 years ago, the OCA has grown
to an International Association of DOs, MDs, DDS/DMD and
Non-Physician Osteopaths. This year’s Conference will focus
on the work of Anne Wales DO FCA.
Course Directors Hugh Ettlinger DO FAAO FCA and Zina
Pelkey DO FCA have planned an outstanding program which
can be found elsewhere in this issue. Throughout this year we will be featuring
the writings of Dr. Wales and the work she did both in training with Dr. William
Garner Sutherland as well as leading the New England Study Group of
Osteopathy in the Cranial Field for many years. Dr. Wales delivered the
Sutherland Memorial Lecture (SML) on two occasions in 1974 and 1993. Those
lectures as well as all other SML lectures will be reprinted in a volume edited by
Melvin Friedman DO FCA which will be available at the 70th Anniversary. We
are inviting all living Sutherland Memorial Lecturers to attend the Conference
and sign their lecture at a large autograph session. This will be a conference
you won’t want to miss.
Dr. Wales attended the American School of Osteopathy in Kirksville, Missouri
from 1922 to 1924 and the Kansas City College of Osteopathy from 1924 to
1926. She practiced as a Physician and Osteopathy in Rhode Island for 50 years
from 1927-1977. She first heard Dr. Sutherland lecture in 1943 at a meeting of
the Eastern States Osteopathic Association in New York City, and began to
study with him in 1944. She attended study sessions in the home office of Drs.
Howard and Rebecca Lippincott for over five years. She also attended classes
presented by Dr. Sutherland in OCF at the College of Osteopathy in Des Moines,
Iowa, where Paul E. Kimberly DO (a past president of The Cranial Academy)
was a Professor of Anatomy. Her legacy in OCF as a student of Dr. Sutherland
and as a teacher of so many Physicians and Osteopaths in the New England area
is well known and well documented. For many years, the Introductory (Basic)
Course of the OCA utilized the manual that was written by Dr. Wales.
Osteopathy in the Cranial Field owes much to the work of Anne Wales DO FCA
and this conference will be a testament to her unwavering commitment to OCF,
a field that honors its teachers and inspires its students. Truly, Dr. Wales is the
link from “generation to generation” for those who practice Osteopathy.
Judith Lewis DO FCA will be directing a course on Biomechanics, addressing the
lymphatics through the myofascial system. It will be held in February, following
the Introductory Course in Atlanta. You can get more information on the course
as well as register on our website, www.cranialacademy.org.
Also, Paula Eschtruth DO FCA will direct an advanced course in the work of Dr.
Robert Fulford open to those who have taken her Introductory Course, either in
Portland earlier this year or at NYIT, providing that other registration criteria
are met. It will likely be held in Portland, the weekend of April 21-23, 2017.
Wishing each of you a meaningful holiday season coming up next month and a
successful and healthy new year.
Respectfully submitted,
Sidney N. Dunn
Executive Director
President’s Message
Dear Colleagues:
There have been two important
developments regarding Medicare
reimbursement in the past few months. The
first involved a proposal by the National
Government Services (NGS) to change how OMT is
reimbursed with regards to ongoing care, maintenance care,
prevention, and also the role of the office visit (E&M) with
OMT procedure codes. This proposed Local Coverage
Determination (LCD) was specific to 10 states in the
Northeast, but if these changes had been adopted, they could
have spread across the country to other Medicare
administrators and to private insurance.
The AOA, under the leadership of President Boyd Buser,
took this threat very seriously and organized a response
across the profession focusing at first on the 10 states
involved and their state organizations along with the AAO
and the ACOFP. The OCA helped spread word among the
profession as soon as we were aware. Over 5000 physicians,
students and patients submitted responses to the
www.SaveOMT.org website which were forwarded to NGS,
resulting in the modification of this LCD to accept the
wording proposed by the AOA.
The second issue is Medicare’s plan to review the relative
values for OMT codes along with 78 other CPT codes that are
frequently billed with an E & M. While the AOA is working on
improving reimbursement for OMT in general, this CMS
review would result in severely limiting the coding of an
E&M plus OMT at the same visit.
The AOA mobilized DOs to oppose this issue again utilizing
the www.SaveOMT.org website. AAO President Laura Griffin
and the AAO Osteopathic Medical Economics Committee also
have been quite involved in these battles. Our members join
the AAO in supporting the AOA’s efforts to confront
Medicare. At the time of the writing of this message, the
results were still pending. However, so far the status quo of
reimbursement for OMT has at least been preserved. We
look forward to a future when OMT coverage will be
expanded with increased reimbursement. For the full text of
the LCD and further updates see our website here:
http://cranialacademy.org/physicians/medicare-
comments/
While none of our osteopathic organizations fit each of us
perfectly, and none represent all of our beliefs, supporting
each other is crucial to the future of the profession. This does
not mean that we fail to hold each other accountable to our
highest ideals. However, if we fail to work together, we will
achieve nothing more than aiding those outside the
profession who wish to see us all disappear.
The AOA has not always been at the forefront of defending
cranial osteopathy, but its very survival may depend on its
ability to defend and promote the physician-based practice
of osteopathy in the future. Osteopathy will never disappear.
It is growing across the world. However, the uniquely
American physician-osteopath educational model is in grave
danger, given how few DO graduates practice osteopathy
with any expertise. With the first OMM specialist as
The Cranial Letter, November 2016, Volume 69, Number 4 3
President in a generation and the ACGME single pathway
looming, there is hope the AOA will dig on and support a
deeper practice of osteopathy. This is especially relevant
when in 2017 we will mark 100 years since the passing of
Andrew Taylor Still.
When we think back on the world Dr. Still entered in the
early 1800’s, he was born before the Industrial Revolution
and lived to see the beginning of the automotive and
aerospace ages. Dr. Still began his study of medicine under
his father, who was a doctor and missionary to the Shawnee
in what is now Kansas. Later, as a practicing physician, he
would keep up to date on the developments in physiology
and pathology coming from Europe. In creating the
osteopathic profession on the frontier far from the ivory
towers of the Northeast US or Europe, Dr. Still merged the
holistic, nature based philosophy of his early native
American patients with the evolving modern science of
European medicine. This uniquely American contribution
would spread around the world and influence many who
came after him.
We owe a great debt of gratitude to Dr. Still for discovering
osteopathy and building a profession not on technique and
rote protocols but on a direct relationship with the natural
world. This absence of technique from any of his writings is
striking to those who do not practice osteopathy. His legacy
was passed to his students who became teachers, from hand
to hand. One of the great dangers of the ACGME single
pathway is that osteopathy could be reduced to a series of
techniques, steps or protocols for each diagnosis. This would
severely limit its effectiveness. The burden is on the AOA and
the AAO to ensure that osteopathy remains whole during this
process of political reorganization in the American medical
system. It is the job of our membership to support those
working in the political arena and at the same time hold
them accountable.
Within this context, we look forward to the upcoming 70th
Anniversary OCA Annual Conference The Legacy of Anne
Wales: Passing Osteopathy Hand to Hand, directed by one of
her longtime students, Hugh Ettlinger, DO, FAAO, FCA. For
the first time, Dr. Sutherland’s complete approach to the rest
of the body will be presented in a single conference.
Dr. Sutherland described the approach to osteopathy that
he had learned from Dr. Still in terms of balance. But what
did he truly mean by this? We cannot fully know simply from
reading his texts. We know that he taught his first students,
those who would become his teaching faculty, as much as he
could. One of his most brilliant and longstanding faculty
members was Anne Wales, DO. She, and the rest of
Sutherland’s faculty, carefully taught his work to generations
of osteopaths. She assembled and edited his writings into
Contributions of Thought and Teachings in the Science of
Osteopathy. Around Dr. Wales evolved a study group of
students who learned from her and with her for decades.
But what is balance? Is it applied as a technique? An
approach? A style? A way of interfacing with the body and
with the primary respiratory mechanism? Just as no one
would confuse simple notes, scales and chords with music,
no one should confuse techniques with osteopathy. This
conference tackles the topic of how to turn simple principles
into a deep and life-long approach to working with a living
and breathing, intelligent system, the primary respiratory
mechanism. For beginners and seasoned osteopaths alike,
exploring the fundamentals brings new insights and greater
depths, passed directly from Dr. Still to Dr. Sutherland to Dr.
Wales. There could be no one better than her closest
students to bring this lineage alive at our Annual Conference
in June in Minneapolis. Please register early as we will have a
6:1 student-faculty ratio, unique at an OCA Annual
Conference.
We also look forward to many excellent OCA courses this
year in addition to our regular February and June Intro
courses including:
 Biomechanics: Addressing the Lymphatics Through
the Myofascial System with Director Judy Lewis in
Atlanta in February following our Intro Course in
Atlanta in February.
 The Teachings of Dr. Fulford II directed by Paula
Eschtruth in Oregon in April
 The Cranial Base directed by James Binkerd in
October
 Opthalmologic Principles with Paul Dart in Oregon in
November
Our colleagues at the SCTF, OPC, and AAO are also
presenting many exciting courses. For a complete and
regularly updated listing of OMM courses in the U.S. see our
website: http://cranialacademy.org/events/cme/
Finally, I wish to thank all of you for your contributions to
our profession and our patients as well as for giving me the
opportunity to serve.
Sincerely,
Daniel Shadoan, DO
President of the Osteopathic Cranial Academy

“Orofacial Development: Merging Osteopathy in the Cranial

Field and Functional Dentistry”
The 2016 “Orofacial Development: Merging Osteopathy in the Cranial Field and Functional
Dentistry” directed by Eric J. Dolgin DO FCA, attracted 41 participants. The registrants
included 30 DOs, 3 MDs, 6 DDS and 3 international participants.
Held at the Hilton Hotel Irvine, California, the course Faculty represents 308 years of
combined experience from seven different osteopathic colleges and three medical
colleges.
In addition to Dr. Dolgin, the faculty consisted of Charles A. Beck DO FAAO; Jose L. Camacho
DO; Junella T. Chin DO; Paul E. Dart MD FCA; Kathryn E. Gill MD; Annette Hulse DO; Hieu M.
Nguyen DO; Darick A. Nordstrom DDS and Tasha L. Turzo DO. The Table Trainers-in-
Training were Melvin R. Friedman DO FCA; Jill E. Moorcroft DO; Thomas A. Moorcroft DO
and Wendy S. Neal DO.
The course was very well received. Some of the comments from the evaluations were:
• The best bridging of Cranial Osteopathy and Dentistry I’ve experienced in my 35 years.
Kudos and deepest appreciation for an amazingly eye opening course. All excellent, high level communicators, clinicians and
amazing skill sets.
• All table trainers were very knowledgeable about lab material as well as addressing our questions with thoughtful care as to
bring in specifics of our course and personal experiences.
• Overall all labs were great learning and palpatory experiences! Helped get the big picture as well as pickup details of dental
diagnosis and customizing assessment treatment etc.

Recommendations for Nominations

Return to the office of The Osteopathic Cranial Academy by December 15, 2016.
Suggested Nominees for President-Elect of The Osteopathic Cranial Academy
(Any Regular member who has served at least two consecutive years as a member of the Board of Directors prior to their election
to such office may be recommended for this office. Certificate of Proficiency is recommended.)
Nominee: Rationale:
Suggested Nominees for Secretary of The Osteopathic Cranial Academy
(Any Regular member who has served at least two consecutive years as a member of the Board of Directors prior to their election
to such office may be recommended for this office. Certificate of Proficiency is recommended.)
Nominee: Rationale:
Suggested Nominees for Directorships of The Osteopathic Cranial Academy (2 will be nominated)
(Certificate of Proficiency is recommended.)
Nominee: Rationale:
Nominee: Rationale:

Submitted by: Date:

4 The Cranial Letter, November 2016, Volume 69, Number 4

 2017 Osteopathic Cranial Academy Annual Conference
The Legacy of Anne Wales: Passing Osteopathy Hand to Hand
June 15-18, 2017
Conference Directors: Hugh Ettlinger DO FAAO FCA and Zina Pelkey DO FCA
Schedule
Thursday, June 15
2:00 p.m. Registration 10:15 a.m. Moving Lymph Centrally (Lab)
3:45 p.m. Welcome Hugh M. Ettlinger DO FAAO FCA
Daniel A. Shadoan DO 11:15 a.m. Moving Lymph in the Periphery (Lab)
3:50 p.m. Introduction and Overview Hugh M. Ettlinger DO FAAO FCA
Hugh M. Ettlinger DO FAAO FCA 12:00 p.m. Lunch/Committee Meetings
4:00 p.m. The Life and Work of Anne Wales DO FCA 1:30 p.m. Sutherland Memorial Lecture (Lecture)
(Lecture) Jane E. Carreiro DO
Jane E. Carreiro DO 2:30 p.m. Lumbar Region and Hip (Lecture)
4:35 p.m. Dr. Sutherland’s Concepts (Lecture) Mary S. Bayno DO
Michael P. Burruano DO FCA 2:50 p.m. Treating the Lumbar Region and Hip (Lab)
5:10 p.m. Connecting to the Mechanism (Lab) Mary S. Bayno DO
Rachel Brooks MD 3:30 p.m. Discussion in Small Groups
6:00 p.m. Living Anatomy of the Sacrum and Pelvis 3:45 p.m. The Knee Joint (Lecture)
(Lecture) Stefan Hagopian DO FAAO
Hugh M. Ettlinger DO FAAO FCA 4:05 p.m. Treating the Knee (Lab)
6:30 p.m. Dr. Wales Pelvic Technique (Lab) Stefan Hagopian DO FAAO
Hugh M. Ettlinger DO FAAO FCA 4:45 p.m. Foot and Ankle (Lecture)
6:30 p.m. Treatment of All Participants/Student Lab Mary S. Bayno DO
7:00 p.m. Adjourn 5:15 p.m. Treating the Foot and Ankle (Lab)
Mary S. Bayno DO
Friday, June 16 6:00 p.m. Adjourn
9:00 a.m. The Fascias in Life (Lecture) 7:00 p.m. President’s Reception
Andrew M. Goldman DO 7:30 p.m. Recognition Banquet
9:45 a.m. Lifting From the Base (Lab)
Andrew M. Goldman DO Sunday, June 18
10:45 a.m. Discussion in Small Groups 9:00 a.m. Thoracic Spine (Lecture)
11:00 a.m. The Diaphragm (Lecture) Lisa Milder DO
Sue Turner DO 9:20 a.m. Treating the Thoracic Spine (Lab)
11:30 a.m. Releasing the Diaphragm (Lab) Lisa Milder DO
Sue Turner DO 10:00 a.m. Discussion in Small Groups
12:15 p.m. Lunch/Committee Meetings 10:15 a.m. Cervical Spine (Lecture)
1:45 p.m. Functional Anatomy of the Ribs (Lecture) Stefan Hagopian DO FAAO
Kathryn Gill MD 10:35 a.m. Treating the Cervical Spine (Lab)
2:05 p.m. Dr. Sutherland’s Rib Technique (Lab) Stefan Hagopian DO FAAO
Kathryn Gill MD 11:15 a.m. The Cranio-Cervical Junction (Lecture)
2:45 p.m. The Thoracic Inlet and its Fascias (Lecture) Sue Turner DO
Donald V. Hankinson DO 11:35 a.m. OA/Condylar Decompression (Lab)
3:15 p.m. Approaching the Inlet (Lab) Sue Turner DO
Donald V. Hankinson DO 12:15 a.m. Managing the Fluctuation of Cerebrospinal
4:15 p.m. Discussion in Small Groups Fluid (Lecture/Lab)
4:30 p.m. Fascial Drag, the Posterior Cranial Fossa, Andrew M. Goldman DO
the RTM, and the Pineal (Lecture) 1:15 p.m. Adjourn
Michael P. Burruano DO FCA
5:00 p.m. The Tension Spring (Lab) Conference Location
Michael P. Burruano DO FCA Hyatt Regency Nicollet Mall
6:00 p.m. Adjourn 1300 Nicollet Mall
6:00 p.m. Annual Membership Meeting Minneapolis, Minnesota 55403
612-370-1234
Saturday, June 17 $149.00/plus tax per night
9:00 a.m. Promoting the Interchange of Fluids
Rooms will be available until May 15, 2017 or until the
Across all Tissues Interfaces (Lecture)
block is sold whichever occurs first. After May 15, 2017,
Hugh M. Ettlinger DO FAAO FCA reservation requests will be confirmed on a space
10:00 a.m. Discussion in Small Groups available basis.

The Cranial Letter, November 2016, Volume 69, Number 4 5

 The Biomechanics of Delight:
Deepening Our Understanding of Osteopathy as Medicine

This course will cover the posture and movement of the body which yields ideal
myofascial tissue quality and maintains ideal biomechanics. The biomechanics
especially addresses Sutherland’s concerns about improper posture and subsequent
breathing mechanics that “disregard physiologic law.” Seeing the muscles as an anti-
gravity mechanism, movement and flexibility with this system is light and easy,
achieving an enhanced physiology with an endorphin-like “body joy.” This course will
be very hands-on, with video and exercises so the participants can take this information
back to their practice and use it in patient care. Interestingly, when the lymphatic
function of the muscular system improves, the nature of the Chapman neuro-lymphatic
reflex point control of the biomechanics of the body becomes apparent.
When Fred Mitchell, Jr. DO FAAO FCA was a child, he nearly died from a severe
burn resulting in azotemia and acute renal failure, a condition which was generally fatal
“Single Point Bronze” by Kevin Pettelle
at that time. Years before the wide array of drugs or IV therapy were available, using
Chapman reflex treatment and Frank Chapman’s philosophy, Charles Owens DO saved
his life. However, very few osteopathic physicians treat these points now, possibly because our understanding of treatment
leads to less effective outcomes. This approach brings up many questions about fascial restriction specifically related to
sympathetic nervous system activation by those points lodged in the fascia and Frank Chapman’s thoughts about lymphatic
function within the body.

Prerequisites: Successful completion of one Osteopathic Cranial Academy Approved 40-hour Introductory Course.

Registration Form
Name (Print) AOA #

Address

City, State, Zip

Phone: Osteopathic College Year of Graduation

Date and place of cranial course taken

Registration fee includes CME and lunches. Circle appropriate fees.

OCA Member (On or before January 15, 2017) ........................................................................................................................... $825.00
OCA Member (Postmarked on or after January 15, 2017) .......................................................................................................... $875.00
Qualified Nonmember ................................................................................................................................................................................. $900.00
Total ........................................................................................................................................................................................................................ $

Paid by: Check MasterCard/VISA/AMEX# Exp. Date

Security Code

Signature:

Cancellation policy: All cancellations must be received in writing and are subject to an administrative charge of 15% of the
deposit for cancellations received at the office of The Osteopathic Cranial Academy on or before January 15, 2017. The entire
registration fee will be forfeited for cancellations received after January 15, 2017, or for failure to attend. There is no discount
for persons not wishing to attend food functions. No personal taping is permitted.

Rooms will be available at the Hyatt Regency Villa Christina, until January 20, 2017 or until the block is sold
whichever occurs first at a rate of $139.00 per night. After January 20, 2017, reservation requests will be confirmed on a
space available basis.
Register online at www.cranialacademy.org

6 The Cranial Letter, November 2016, Volume 69, Number 4

 “Teachings of Robert Fulford DO FCA II”
April 21-23, 2017
Course Director: Paula Eschtruth DO FCA Associate Director: Sarah Saxton DO
Portland, Oregon
20 Hours Category 1-A AOA CME (anticipated)
The “Dr. Fulford’s Philosophy of Life and Advanced Percussion Course” is the second segment of a two-part
program presented by Paula Eschtruth, DO, FCA, and Sarah Saxton, DO. The purpose of this course is to build upon
the concepts introduced in the basic course, furthering one’s understanding of Dr. Robert Fulford’s philosophy in
his approach to treating the whole body and in his use of the percussion hammer. Dr. Fulford’s advanced
percussion and manual approaches will be explored. Love and self-healing, core aspects of Dr. Fulford’s work and
life philosophy, are interwoven throughout the course. Drs. Eschtruth and Saxton both worked extensively with Dr.
Fulford and are committed to sharing their knowledge and continuing his work.
______
“The human body is composed of complex interflowing streams of moving energy. When these energy streams
become blocked or constricted we lose the physical, emotional and mental fluidity potentially available to us. If the
blockage last long enough or is great enough, the result is pain discomfort, illness and distress.” Robert C. Fulford ,
DO
______
In this course, Drs. Eschtruth and Saxton will share their knowledge derived from working directly with Dr. Fulford
and applying the principles of his unique osteopathic viewpoint to their personal and professional lives.
Philosophic discussions and hands-on practice will be complimented by personal stories of their time with Dr.
Fulford. Get to know Dr. Fulford in a more personal manner and gain a greater understanding of his work so you
can more effectively find health in your patients.

Prerequisite:
Successful completion of a Basic Percussion and Fulford Philosophy with Paula Eschtruth

Registration Form
Name (Print) AOA #

Address

City, State, Zip

Phone: Osteopathic College Year of Graduation

Date and place of cranial course taken

Registration fee includes CME and lunches. Circle appropriate fees.
OCA Member (On or before March 15, 2017) ............................................................................................................................... $850.00
OCA Member (Postmarked on or after March 15, 2017) ............................................................................................................. $950.00
Qualified Nonmember ............................................................................................................................................................................. $1,000.00

Total ........................................................................................................................................................................................................................ $

Paid by: Check MasterCard/VISA/AMEX# Exp. Date

Security Code

Signature:

Cancellation policy: All cancellations must be received in writing and are subject to an administrative fee of 15% of the total registration
fee if received on or before March 15, 2017. Refunds will not be made for cancellations received after March 15, 2017, or for failure to
attend. Meal tickets included with the registration fee are not refundable. There is no discount for persons not wishing to attend food
functions. No personal taping is permitted. It is the responsibility of ALL participants to use the information provided within the scope of
their professional license.
Register online at www.cranialacademy.org
The Cranial Letter, November 2016, Volume 69, Number 4 7
 Scientific Section
An Osteopathic Approach to Ophthalmic and Optometric
Disorders: Part 3
Anthony Capobianco, DO
(Part 3 of this article is respectfully dedicated to the memories of Drs. Viola Frymann and Anne Wales)
Dr. Wales’ stated rationale behind SPG treatment was that
the structure is “a parasympathetic ganglion with secretory
and sympathetic (vasoconstrictor) connections...distributed
to the mucosa of the upper respiratory region, the palate and
pharynx.” At the core of the technique “Stimulation occurs as
the change in shape of the fossa and orbit and is influenced
by a manual operation based on contact at the root of the
pterygoid processes.”48 In the sequence presented, it is
preceded by intraoral release of the zygoma then the palatine
sutures but before the Cant Hook technique (see below) for
frontosphenoidal suture release. For release of the SPG per
se, the operator standing on the opposite side of the supine
(or seated) patient introduces a gloved or cotted pinky finger
traveling across the lateral outermost surface of the upper
teeth posteriorly in the buccal space (inside the cheek), past
the rounded posterior border of the maxillary body (non-
tender49), until the flattened outer surface of the lateral
pterygoid plate (possibly tender50), is encountered. At this
point the fingertip is brought in medially, then posteriorly “so
as to advance toward the root of the pterygoid process as far
as practical.”51 The fifth finger (pinky) tip will usually fit in
the fossa, surrounded by four walls, so to speak. The
restrictive barrier is engaged and held allowing the patient to
titrate innate forces whereby the PRM breathing and
secondary thoracic breathing assist in rhythmically altering
the SPG fossa to attain release, which can be sensed in
restoration of its parts: the sphenoid, palatine and maxilla.
Having the patient flex their head forward, as Dr. Wales
taught, is unnecessary. In the cases that follow, since
tenderness is common, passive ROM is applied during the
OMT procedure for the SPG and associated tissues yielding
more consistent results. The effect on the lacrimal gland
when observing tearing indicates that this particular release
has allowed stimulation of the SPG; however a release can
occur in the absence of tearing, which is far more common, as
well. If the opposite side is treated, differences in the spaces
of the two fossae reflecting sphenoidal rotation upon an
anterior - posterior axis52 (as in SBS torsion and sidebending
rotation strains) can be appreciated. The correction of facial
strains, especially the zygomatic articulations “to the
temporals and maxillae, as well as to the greater wings in the
lateral walls of the orbits, will also tend to stimulate the
SPG.”53 Release of fronto - sphenoidal articulations (see Cant
Hook technique below) are often the most important
interventions in restoring motion for the sphenoid.
Sphenoidal motion positively influences the pterygopalatine
fossae, and in turn benefits SPG function. Conversely, “if the
pterygoid processes are not free to move to and fro in the
8 The Cranial Letter, November 2016, Volume 69, Number 4
palatal grooves the action of the sphenoid may be limited in
all relations. In such a case addressing the pterygopalatine
problem is of first importance.”54 Even though OMT via the
fingertip in the fossae achieves this, all intraoral techniques
described deserve consideration for a more comprehensive
approach to eye illness by complementing and completing
external globe and orbital OMT. Taken as a whole, all
intraoral and extraoral techniques seem to optimize SPG
function so are routinely performed, as the cases show, and
are listed as essential to the core local eye treatment
sequence at the culmination of these articles.
As mentioned, Dr. Wales asserted that release and re-
alignment of “the fronto-sphenoidal articulation is often the
most important step in getting freedom of motion for the
sphenoid.”55 Therefore, a review of Dr. Frymann’s tutorial on
the Cant (the abbreviation for cantilever) Hook technique for
the frontosphenoidal articulation, for eye disease, is
pertinent. Standing opposite to the involved articulation, the
gloved operator’s pinky pad travels inside the cheek opposite
the operator, posteriorly from the outer surface of the upper
teeth past the rounded maxilla until the flat outer lateral
pterygoid plate is contacted. The index finger pad contacts
the greater wing around two fingerbreadths posterior to the
lateral angle of the eye. With the other hand, the thumb
contacts the proximal great wing, acting as a fulcrum, and to
lift superiorly, while the opposite lateral frontal (lateral to the
temporal lines in the temporal fossa) is lifted superiorly by
the middle finger of the same,56 for disengagement of the
frontosphenoidal articulation. For more long-standing, severe
lesioning, the compression component of the strain can be
exaggerated, as Dr. Frymann advised. To “compress it into the
compression,”57 prior to direct or even indirect release, if a
direct approach is not fruitful, is acceptable. If the operator’s
thumb cannot reach it due to a small hand size, contact with
the proximal greater wing is optional. Next, she taught to
follow this up by sliding the frontal contact medially onto the
superior orbital margin. This allows for an ipsilateral
intraosseous sphenoidal treatment as one hand is in contact
with the sphenoidal lesser wing (through the frontal) and
body, and the other through contact made inside and outside
the mouth, with the sphenoidal greater wing and pterygoid
unit (the physiologic movements of these two structures
follow flexion and extension). She then advised it is well to
remember “why we use direct action when you’ve always
been taught to use an indirect action…especially in adults… In
children, little children – you most always use direct…the
direct action is the action of choice, but there is no absolute
rule. If direct action cannot overcome a problem …present for
many years, then you just use indirect action and wait for it
to release.”58 Recall that prior to movement -limiting
interdigitations of cranial sutures and fusion of the
preosseous elements of the sacrum, atlas, occiput, temporals
and sphenoid, are complete at around nine years of age,
direct treatment prevents exaggeration and thus crowding of
the vulnerable neural tissue associated with these bones,
such as the cerebrum, medulla, CNs and cord. This series of
articles reflects the extensive and effective use of direct
action for children and adults, alike.
The presentation of the patient’s case and time available for
diagnosis and treatment often dictates what occurs, or can
occur in the treatment session. The patient’s sense of
urgency, and the time available for treatment set the tempo
of the visit. In general, the acuteness of intensity of illness or
injury often evokes a commensurate intensity of OMT: most
eye illness seems to elicit fear not seen in other conditions. (It
is telling that the first homeopathic remedy indicated for
acute eye trauma is Aconite, a medicine associated with
intense fear.) In order to ensure or increase likelihood of
follow up, global somatic work may have to wait or be
limited, while the chief complaint is directly addressed and
improved in terms of symptom intensity, duration and
frequency. Patients with chronic eye (or any) illness are apt
to follow up if the initial eye visit yields any improvement, as
many want to avoid further drugs and surgery, often having
already tried these to no avail.
On a new patient visit, when symptoms are not forthcoming,
or a more objective assessment is desired, a bilateral hand
screening or focal facial scanning of the globe and orbit
complex accessed together or individually, in the supine or
even prone patient approach. This contact consists of the
volar aspects of the operators hands draped over the face,
specifically lateral thumb pads on either side of the usually
fused metopic suture for frontal bone(s), index finger pads on
nasals, middle and ring fingers on globes and pads on
maxillae and pinky pads on zygoma. The restricted or more
restricted eye will be discernable. Alternately, the fingers and
pads two, three and four of both digits can overlie the orbits
and globes (lids are closed in all osteopathic manipulative
diagnosis and treatment) and, usually, inherent decreases in
CRI noted in these structures. In the majority of cases that
follow, this three-finger pad contact upon each maxilla, globe
and frontal of each eye, both simultaneously, is employed and
referred to as bilateral ocular/orbital palpatory scanning. To
help in ophthalmic diagnosis, Dr. Jealous instructed one to
discern if the eyeball had a uniform swelling and receding
consistent with the cranial mechanism and further, to
compare the fluctuation of the CSF in the globe to that of the
vault.59 The orbits and globes can be scanned separately,
bilaterally and even unilaterally with a non - eye contact on
the opposite contralateral, approximately middle, of the
occiput.60 From this contact, orbital and ocular diagnosis and
treatment can occur, as well as the pyramidal projection of
potency and allowing direction of the Tide for diagnosis and
treatment of strain patterns, can occur. Dr. Frymann wisely
advised osteopathic intraoral exam for restrictions including
ruling out the presence of rubber banded orthodontia and
oral appliances as a source of persistent Potency projection
strains.61 Restriction surrounding or within the eyeball itself
(i.e. Potency, sclera) can manifest as either a sunken or
The Cranial Letter, November 2016, Volume 69, Number 4 9
excessively full and protuberant sensation. A sensation of
hardness can correlate with increased intraocular pressure
associated with glaucoma, or any of a myriad of non-
glaucomatous eye conditions, as the cases herein illustrate.
The following cases might well serve to develop an
understanding of eye OMT techniques and orient the
traditional osteopath to frame approaches to acute and
chronic eye disease in the clinic. An early case, M.C. was a 30-
year-old housewife who presented with a chief complaint of
left orbital and ocular “toothache” pain, and tearing of three
days duration. The patient stated that her left eye pain and
watery discharge was constant and worse with lid closure.
Chronic symptoms of a left sided paranasal sinusitis,
postnasal drip and hoarseness were also present. She
admitted to recalling multiple nasal injuries in grammar
school, one in particular being a fist blow to the nose, which
resulted in anterior nasal bleeding. The past surgical history
was negative and the patient denied caffeine, tobacco, alcohol
use, or any special diet. She was currently not on any
medications and had no known allergies.
Physical examination revealed visual acuity and anterior
chamber depth were normal. Conjunctival injection, corneal
haze, ciliary flush and photophobia were absent. Present was
an exquisite tenderness at the left medial orbital area. Edema
and tension were palpated in the left periorbital soft tissues.
Local osteopathic three-finger pad bilateral palpatory
scanning revealed restriction, or decreased range, in the
inherent motion of the components of her left bony orbit.
This was arrived at from a bilateral second and fourth finger
pad above and below the orbital margins, respectively while
third finger pads contacted each eyeball through the closed
lids without contact lens, which are commonly not in place
during acute eye illness. It was said that covering a young
child’s eye can be too fear provoking so, although not as
effective, the palpatory contacts are best above and below the
orbit.62 However, the operator can always attempt, and often
succeed, with the bilateral palpatory scanning contact,
proceeding accordingly to tolerance, which often prevails,
while aiming for a swift diagnostic impression. Dr. Jealous
wisely advised supporting elbows on the OMT table for eye
diagnosis.63
The initial assessment was left dacryocystitis from acute
exacerbation of mechanical trauma induced chronic somatic
dysfunctions of the viscerocranium. Dacryocystitis is an
inflammation of the nasolacrimal sac frequently caused by
nasolacrimal duct obstruction or infection; this was the root
cause indicated by a history of nasal trauma (present in the
above case).64 The treatment plan was for OMT to be
administered using direct and indirect procedures to
alleviate somatic dysfunctions in the cranium, thereby
allowing the involved eye to heal.
While seated at the head of the OMT table with the patient
supine, treatment commenced with an occipital CV4 as an
anti-inflammatory measure and to facilitate or highlight more
specific corrections, as it is capable of resolving secondary
lesioning. In subsequent cases the occipital CV4 is left for the
end pending the completion of the local eye OMT sequence.
Next, the Periorbita was released via insertion of the distal
digit between ocular globe and orbit, engaging and
maintaining forces at the restrictive barriers allowing PRM to
provide releases. (Approximately a quarter to a half-
centimeter or so insertion of the fifth fingertip(s) between
orbit and globe, at the superior and inferior orbital folds,
usually suffices.) The fingertip can directly offer tremendous
influence upon the bulbar fascia or Tenon’s capsule;
connective tissue contiguous and in proximity with a soft
tissue complex of plates, septra, ligaments, tendons, and
aponeuroses of extraocular muscles (EOM) s. This allows
manipulative influence over the fascia of the lids, bulbar
conjunctiva, sclera, EOM muscles and fascia, including the
sheath of CN II.65, 66 This was done in a stepwise fashion
around the entire circumference of the involved globe. In the
cases that follow, sites of greatest restriction detected and
released are noted. Because of the infectious inflammation in
this case, to optimize lymphatic and venous drainage first so
as to minimize tenderness, the medial aspect was left for last.
Next, as Dr. Jealous taught, contact was made with one index
fingertip of one hand on the zygoma and the one fingertip
from the other hand on the lacrimal ridge of the lacrimal
bone primarily for release of a ligamentous strain in the
“suspensory membrane of the globe” via its bony
attachments, respectively. (The suspensory membrance of
the globe is often referred to as “membrane” in these articles,
it is synonymous with external and internal palpebral or
tarsal ligaments and palpebral fascia, tarsal membrane or
septum orbitale,67 essentially a fascial band with an aperture,
not to be confused with the suspensory ligament of the ciliary
body) via its bony attachments, respectively. (He stated that
the biomechanics and biodynamics of this system are usually
restricted in pterygium and glaucoma, the latter since “it
suspends the globe near the ciliary body so that this
mechanism can influence fluid dynamics in the anterior
chamber in the eye.”68 Recall the need for ease and range of
motion to allow ciliary muscle motion to allow the lens to
change shape to accommodate for rapid changes in diverse
focal lengths, as well as the muscular diaphragm of its
attachment, the iris, for changes in aperture for light.69) The
lacrimal puncta and canaliculi are enveloped within the
medial aspect of the upper and lower lids, or tarsal plate’s
medial ligaments, which determine the flow of tear fluid in
them.70 The strain pattern happened to be reduced, in this
instance, by following the tissue to the point of balanced
ligamentous tension for indirect release. In addition, releases
of the suspensory membrane technique can also positively
influence the orbicularis oculi muscle. Functioning as a
sphincter for the eye, this striated muscle with voluntary and
involuntary (sympathetic) input, has an attachment to the
lacrimal bone medially (in addition to the frontal bone), and
zygomatic bone via the lateral palpebral (eyelid) ligament, via
the lateral palpebral, therefore is also manually addressed
with the membrane technique.71 Blepharospasm represents a
protective guarding mechanism (as in any muscle spasm local
to injury or inflammation), of the orbicularis closing the lid,
usually in response to disease in other parts of the eye.72 Not
surprisingly it is usually resolved when the eye pathology is
addressed with the eye OMT sequence, which is
comprehensive, and also includes the lid influential
membrane technique.
Dr. Frymann put forth that anatomical distortion from
cranial strain patterns, especially those from birth trauma,
impeded myelination of neuronal pathways (associative
pathways in contradistinction to isolated neurologic centers
10 The Cranial Letter, November 2016, Volume 69, Number 4
for motor/organ function) from disruption of normal
geometric relationships and formative processes in the
cranium. For this discussion, the orbital pyramidal projection,
key for vision, is vulnerable to injury, and is discussed below
and in detail in the first case following. This holds true for the
temporal pyramid and projection, for hearing, and
equilibrium, as well.73
Intraosseous temporal lesioning can be released, even
before pre-osseous elements (recall there are three separable
parts at birth: squamal, petrous, lacking a mastoid portion,
and tympanic, an incomplete horse shoe - shaped ring
superiorly without depth, hence the tympanic membrane is
close to the skull surface74). This can be accomplished by
contacting both the lesioned temporal, use of the traditional
five point contact (above) for instance, and contralateral
maxilla, with a few crowded fingertips. Doing this it allows
the Tide to be directed, while all barriers are sensed and
engaged, a technique extensively used by Dr. Frymann in her
pediatric clinic.75 She also taught more specific intraosseous
work with contacts between the petromastoid and external
auditory meatus, the petromastoid and the squama and the
squama and external auditory meatus (tympanic ring).76
Next, Dr. Frymann described a temporal pyramidal projection
technique, following the geometry of the petrous part, for
proper myelination, necessary for normal acoustic and
labyrinthine development. A variation is to have one finger in
the supine external auditory meatus (tympanic ring), while
from the other hand’s fingertips cluster on the contralateral
maxilla, providing contacts for indirect or direct techniques,
also assisted by the Tide, being directed by the application of
PRM sensing contacts.77 She credited Dr. J. J. Henderson, a
traditional osteopath practicing in Iowa, who was able to cure
cases of congenital neurologic hearing deficits using these
particular ear techniques.78
The bony orbit, a pyramidal - shaped structure, and its
developmental axis was then treated. Sensed was the
circumference of the base of the pyramid, a cone, accessible
to palpating fingers and the apex projecting lines of force as
Potency, or Tide, for neural pathway growth. This neural
template can occur because posterior to the sella turcica,79
“the axes of the orbits intersect at the optic chiasm on the
body of the sphenoid” and “are then projected to the
contralateral pole.”80 (She linked deviation of this
physiologic trajectory of Potency from birth or early acquired
injury as an indicator of a deviation away from the normal
geometry of orbital configuration, angulation and paired
symmetry, the physiologic crossing through the optic chiasm
to the opposite cranium, as a cause of learning and reading
disabilities, involving the most complex functions, since
strained structural patterns could adversely affect
development and subsequent function of neurosensory
pathways. This was underscored by studies concerning brain
development that indicate the first two years are the most
vulnerable to CNS growth and it is influenced by the integrity
of the fibro-osseous case surrounding it.81) This structural
dynamic is often referred to as the orbital projection or
simply projection in these writings.
The right posterior quadrant of the head was cradled in the
right hand while grouping the fingertips of the left hand on
the borders of the circumference of the orbit: the thumb and
index finger on the frontal, the middle finger on the nasal
process of the maxillary, the fourth on the maxillary, inferior
to the orbital rim, and fifth, on the zygoma (alternately these
contacts can be the third on maxillary and fourth and fifth on
zygoma as per the ease of the operator’s anatomy for easy
finger placement). Release with restoration of the inherent
cranial rhythmic impulse (CRI) motion was attained by
following the orbital circumference to a point of balanced
tension (PBT), which in this case was torsional, in a
counterclockwise (CCW) direction (named as if looking at the
patient’s face facing from the front). With contacts above and
below the orbit so as not to occlude vision and trigger fear,
Dr. Frymann advised a direct approach, by “gradually leading
the impulse to where it belongs,” describing this, as
somewhat of a pediatric equivalent to adult intraosseous
sphenoidal techniques, which “are very difficult to do in small
children.”82 This contact, essentially a V – spread, can also
induce and allow the potency to be directed (so called
“directing the tide”), as in the above mentioned contacts, or in
conjunction with any technique for that matter. Specifically,
follow in the path of least resistance (unloading) then take
the tissue/fluid/fascia/ potency opposite this direction into
the restrictive barrier(s) directly, maintaining force (loading)
for release. Dr. Blood described the rationale for direct
treatment in children as being something to the effect of
“since the bone was never on the right track one must place it
there.”83 In this case, with contralateral contacts, release with
restoration of the inherent CRI motion was attained by also
following the orbital circumference to a point of balanced
tension (PBT), which in this case was torsional, reflecting its
position of lesioning, in a counterclockwise (CCW) direction.
A simple description for direct OMT of the orbital projection
is to sense which way the involved parts want to go, when
challenged with passive ROM, then take them opposite,
engaging the restrictive barrier(s) obtained by stacking
tensions in all axes of motion, therefore obtaining direct
release. For diagnosis, the projection strain pattern is named
relative to the deviation of the normal trajectory of orbital
potency, displaced from the physiologic terminus on the
contralateral occiput, sensed when the above periorbital and
opposite occipital squamal contacts are applied.
In this case, the involved eyeball itself was evaluated for
range of motion (ROM) or resiliency (hardness, softness), and
freedom of motion within the orbit in all circular and linear
directions, and was lacking in both resiliency and freedom of
motion. With eyelids closed, and the fingertips in contact
with the circumference of the orbit as before, the globe was
now grasped between the thumb and index finger of the right
hand accessing it in between those of the left 2nd and 3rd
digits. It was followed into a CCW and medial direction to a
point of balanced tension (PBT) for indirect release. It is
important to note that in the remainder of cases in this series
of articles that follow, for the vast majority of various
diagnoses and techniques applied for their correction, this
was not the approach; unless otherwise specified, it can be
assumed direct action was utilized. This simultaneous
contacting of the globe with the two fingers, and five points of
the globe, as above, is the usual initial technique in the local
treatment sequence for eye OMT.
Recall “The nasolacrimal duct begins at the point where it
enters the osseous nasolacrimal canal of the maxillary bone.
The nasolacrimal duct extends into the nose, beneath the
The Cranial Letter, November 2016, Volume 69, Number 4 11
inferior turbinate.”84 Intraoral exam revealed an inferior left
maxillary bone in relation to the right one. Unilateral
maxillary OMT commenced with the thumb outside and index
finger inside the mouth, and the other thumb and second
digit pad contacting the great wings of the sphenoid (the
extraoral default contact for most one – handed intraoral
OMT), the involved maxillary bone and associated tissue
were released inferiorly, indirectly.
Immediately following OMT the patient reported that she
was without eye pain or postnasal drip. Telephone message
received the following day was that facial lacrimation and eye
pain were gone with an occasional postnasal draining on the
left side, the nasal passages being clearer. In time, this
resolved, as well.
References
48 Wales, DO, Anne: Stimulation of the Sphenopalatine Ganglion for Clinical
Purposes, handout for OCF study group lecture and table session, North
Attleboro, Massachusetts, USA, August 27, 1993, p. 1, 2.
49 Frymann, Learning Disabilities: Intraosseous Lesions Lab Two, p. 23.
50 Frymann, Learning Disabilities: Intraosseous …, p.24.
51 Wales, Stimulation...
52 Wales, Stimulation ..
53 Wales, Stimulation of the Sphenoplatine Ganglion…, p. 2.
54 Wales, Stimulation of the Sphenopalatine Ganglion…, p. 2.
55 Wales, DO, Anne: Stimulation of the Sphenopalatine Ganglion For Clinical
Purposes, OCF study group handout, North Attleboro, Massachusetts, USA,
Aug. 27, 1993, p.2.
56 Frymann, Learning Disabilities, Intraosseous Lab Two, transcription, pp.
23, 24.
57 Frymann, Learning Disabilities, 1985 Annual Cranial Academy Conference
58 Frymann, Learning Disabilities, 1985 Annual Cranial Academy Conference
59 Jealous, “The Eye”
60 Frymann, Learning Disabilities…p.10.
61 Frymann, Sutherland Cranial Teaching Foundation: Continuing Education
62 Ibid.
63 Jealous, DO, James: ‘The Eye” section of a handout entitled “Observational
Diagnosis,” late 1980’s ?
64 Dunphy and Way, p. 787.
65 Pansky, p. 104, 105.
66 Doxanas, MD, Marcos, and Anderson, MD, Richard: Clinical Orbital
Anatomy, Williams & Wilkins, Baltimore/London, 1984, p. 74.
67 Toldt, MD, Carl: An Atlas of Human Anatomy for Students and Physicians,
2nd ed., The Macmillan Co., New York, USA, 1928, p. 909.
68 Jealous, “The Eye’
69 King, p. 117.
70 Kronfeld, MD, Paul: The Human Eye: In Anatomical Transparencies,
Bausch & Lomb Press, Rochester, NY, USA, 1943, p. 49 and fig. 5.
71 Warfel, PhD, John H.: The Head, Neck and Trunk, 5th ed., Lea & Febiger,
Philadelphia, NY, 1985, p.15.
72 Piersol, George A (ed.): Human Anatomy, J.B. Lippincott Co., Philadelphia,
PA, USA, 1907, p. 1446.
73 Frymann, Learning Disabilities…, p.7.
74 Anderson, MD, James E.: Grant’s Atlas of Anatomy, 7th ed., The Williams
and Wilkins Co., Baltimore, USA, 1978, plate and note 10 - 10A.
75 Frymann, personal communication, 1985.
76 Frymann, June 1987 Cranial Academy Conference notes, p. 1.
77 Frymann, DO, Viola: personal communication, La Jolla, California, 1985.
78 Frymann, Learning Disabilities…p. 18.
79 Frymann, DO, Viola: Sutherland Cranial Teaching Foundation: Continuing
Education, University of New England College of Osteopathic Medicine,
Maine, USA, Oct. 16, 1993.
80 Frymann, Handout for Intermediate Course, p. 39.
81 Frymann, DO, FAAO, Viola: Learning Difficulties of Children Viewed in the
Light of the Osteopathic Concept, The American Osteopathic Association,
JAOA, vol. 76, Sept. 1976, pp. 46-61.
82 Frymann, DO, Viola: 1985 Annual Cranial Academy Conference, Infants
and Children, Santa Monica, California, 1985, transcription “Learning
Disabilites, Lab Two Intraosseous Lesions,” p. 22.
83 Blood, DO, Stephen: Introduction to Osteopathy in the Cranial Field
annual elective course, Mid - Atlantic States, late 1980’s, 1990’s, early 21st
century.
84 Doxanas, p. 101.
Macular Degeneration
R. Paul Lee, DO, FAAO, FCA
History:
A 53-year-old female presented with the complaint that a
recent image of her right retina obtained by her optometrist
revealed vascular changes consistent with early macular
degeneration. She wanted to know if I could help before
she went to her ophthalmologist the following week.
Several years ago, the ophthalmologist had performed laser
surgery to reattach this same retina. Her vision seemed to
be degenerating recently, which motivated her to see the
optometrist.
Generally, she has been healthy, aside from some minor
depression and injuries to her fingers. Besides the retinal
surgery, she has had no other hospitalizations. She relates
no allergies and takes no medications. She recalled only
one auto accident in her twenties in which she was struck
from the right side by another vehicle. Her injuries were
minor and she sought no medical attention. Otherwise her
trauma history was negative.
Physical:
Palpatory examination revealed traction on the right optic
nerve. Tracing posteriorly to find the origin of the traction,
it became clear that the optic chiasm was also drawn
posteriorly and to the left. Further back, along the optic
tracts, the thalamus had been shifted to the left and the
lateral geniculate ganglion where the optic tracts
terminated was pulled to the left.
Treatment:
As I watched the thalamus, I could detect that the force
that caused the shift to the left also seemed to spin it on a
vertical axis clockwise creating a fulcrum for the
displacement of the thalamus. As I observed the fulcrum, it
shifted and the thalamus assumed a neutral position. The
thalamus began to breathe with PRM and the fluctuation of
the CSF became quite enhanced for a time.
Once the thalamus achieved full resolution of its distortion
into a position of health, the PRM returned to a normal
healthy rhythm. I then looked at the optic tracts and the
optic nerves. There was now a balance of the positions of
all these parts and the whole system was breathing
naturally including the globe of the right eye. The fulcrum
now shifted to the facial bones, especially the right zygoma
and maxilla. Once these changed their positions and
breathing functions, the whole seemed improved and there
was a stillpoint. Once PRM returned to a normal healthy
quality, the treatment ended.
Follow up:
I saw the patient the following week after she had visited
the ophthalmologist. He carefully examined the eye and
reported no sign of the early vascular changes seen in the
previous image of her retina. I found no traction on the
optic nerve and no shift of the thalamus. We concluded the
visit by saying that if her vision became worse that she
should come back but my expectation was that she would
not have macular degeneration.
12 The Cranial Letter, November 2016, Volume 69, Number 4
Discussion:
In my experience, the thalamus seems to be especially
troublesome in cases of trauma. It is a dense collection of
nuclei, heavier than the surrounding tissue of the internal
capsule made up of axonal tracts heading to the cerebral
cortex. The third ventricle lies between the two halves of
the thalamus allowing a certain amount of independent
mobility of the two parts. The thalamic adhesion, between
the right and left thalamus transiting the slit that
constitutes the third ventricle, stabilizes the two halves of
the thalamus into a more unitary function, however. But
the thalamic adhesion can act as a fulcrum for the two
halves of the thalamus. I commonly see the entire thalamic
structure with the third ventricle shifted en mass, as well.
Or there can be a combination of shifting the whole
thalamus with a twisting around the thalamic adhesion.
Because the optic tracts travel a relatively long distance to
reach the geniculate ganglia in their posterior, inferior
position on the thalamus, the tracts are susceptible to being
stretched by the shifting and twisting thalamus. The softer
density of the surrounding fiber tracts and the fluid of the
third ventricle between the two halves of the thalamus and
the fluid of the lateral ventricles above the thalamus permit
these traumatic distortions of the normal position of the
thalamus. The fluid bath within which the optic nerves
reside within its dural sheath permits tractioning of the
nerves. Cerebrospinal fluid surrounds the optic nerves
inside a dural sheath that is continuous from the sclera on
the posterior eyeball to the meningeal dura within the vault
through the optic canal. CSF surrounds the optic nerve
from the sclera to the chiasm. From there to the lateral
geniculate body in the thalamus, CSF surrounds the optic
tracts as well. This freedom to float in the bath of CSF
allows the entire optic pathway from the retina to the
lateral geniculate body to be subject to traction.
One could speculate that the retinal detachment years
earlier could have been caused by the same trauma that
caused the stretching of the optic nerve. The traction
through the optic nerve on the posterior aspect of the
eyeball could have contributed to the retinal detachment.
The blood supply to the retina and the optic nerve can also
be compromised by malpositions of the diencephalon. The
ophthalmic artery proceeds anteriorly from the internal
carotid as it emerges from the cavernous sinus near the
anterior clinoid process. The ophthalmic artery proceeds
through the optic canal with the optic nerve. Immediately
the central retinal artery branches off the ophthalmic artery
as it enters the bony orbit beyond the optic canal. The
central retinal artery penetrates the dura and enters the
subarachnoid space within the optic nerve. It then enters
the center of the optic nerve itself to emerge in the
posterior eyeball within the optic disc. One diagnoses
adverse vascular changes of the retina by visualizing the
optic disc. Traction on the optic nerve inhibits the flow of
blood within the central retinal artery, which is visible on
retinal imagery at the optic disc.
 Releasing the traction on this patent’s optic nerve by
allowing the thalamus to return to its original position
restored the circulation to the optic disc and resolved the
threat of macular degeneration. There are other causes of
macular degeneration than mechanical ones, but osteopaths
Dental Corner
Massage Table a Perpetuating Factor
Douglas Vrona, DMD
Over the past 30 years, I’ve been treating head/neck/TMJ
pain with a combination of Dr. Travell’s trigger point
injections, physical therapy and cranial osteopathy.
While treating a 47-year-old female physician from India, I
discovered a perpetuating factor which in retrospect caused
multiple relapses prolonging her case. The offender was
found to be weekly massage therapy for her low back and
shoulders utilizing a facial support ring attached to or
within the massage table. The deleterious effects were as
follows:
1) Intra-osseous strains within the frontal bone.
2) Locking of the frontal/ethmoid complex
3) Compression of the sphenobasilar synchondrosis.
4) Fixation of the zygomatic/temporal suture.
5) Retrussion of the mandibular condyle into the
glenoid fossa causing external rotation of the
temporal bones resulting in limited jaw opening.
This was especially prevalent when the TMJ disc
was not in place allowing bone-bone contact.
6) Compression of the maxilla/palatine articulation as
a result of a retruded occlusion.
7) OAA fixation (C1 is the axis of rotation of the upper
& lower jaws).
This patient was referred by a chiropractor whose
treatment had been unsuccessful. Symptoms included
limited, painful jaw and cervical ROM with 10+ left
OAA/shoulder/arm pain.
TMJ corrected axial tomography revealed left TMJ
degenerative joint disease but with normal translation.
Her limited jaw opening was therefore due to a deficient
cervical component. There was total loss of upper cervical
function secondary to major cranial distortion from a
difficult birth including face forward presentation. This
patient’s cervical spine was nearly fused on the left, I
assume a result of bleeding during the birthing process.
(fibrous union)
After six months of manipulation of the cranium, TMJ,
cervical spine, shoulder girdle & thoracic outlet on the left,
this patient has a normal pain free jaw opening, with no
The Cranial Letter, November 2016, Volume 69, Number 4 13
have the opportunity to help this condition if there is a
mechanical aspect to the etiology. Osteopaths also have an
opportunity to change the vascular blood flow if it is not
accompanied by a mechanical distortion. That is another
topic.
head/neck/shoulder pain, and a 100% cervical range of
motion. CRI improved from 6 to 12 cycles/minute.
Trigger point injections were done in the left trapezius,
levator scapular, SCM, scalenes, temporalis, masseter, supra
& infra spinatus to release osseous structures & eliminate
referred pain. Chiropractic manipulation to the low back &
pelvis were done monthly.
This physician has been returned to her chiropractor, who
now successfully maintains her case with full spine
adjustments as needed.
Although she is a severe Class II - Division II malocclusion
(editor’s note: retruded mandible due to upper anterior
teeth tipped in toward the palate), the medical/dental
necessity of a splint or restorative dentistry was
unwarranted.
When I reviewed my patient base, I found several more
stubborn prolonged cases unknowingly having full body
massage or acupuncture using a face ring for support.
Osteopathic treatment without this perpetuating factor has
been far more successful with an end in sight.
If 5 grams of pressure is all that is needed to move a
cranial bone, the deleterious effect of a 10-15 lb. cranial
vault lying on a massage table for 30-60 minutes is worth
noting especially in chronic headache cases.
Any dentist who has a treatment case that involves cranial
osteopathy and dental treatment please submit an article to
me for the Dental Corner. I would be happy to help you with
writing up your case.
James Kennedy, DDS
1190 Bookcliff Ave #101
Grand Junction, CO 81501
Email: drkennedy@dentocranial.net
(970) 242-1900
The Cranial Dental Proficiency Examinations are scheduled.
Please check the website for upcoming events or for further
information contact the Dento-Cranial Competency Board at
540-635-3610. Website: http://dentalcranial.org/home
 From the Archives . . .
In Appreciation of a View
1974 Sutherland Memorial Lecture
Anne L. Wales, DO, FCA

me some insight into how the living human body does its
work and solves its problems. We all agree, I suppose, that
the living body is a self-regulating, self-correcting and self-
healing organism. It is an inspiring fact, especially when
one is sick and in the midst of experiencing the process
which his own body is producing on the way to becoming
well. But it is not nearly as convincing as the facts the
osteopath, as operator, is experiencing in the action that
we call an osteopathic treatment. Dr. Still stated his
recognition of this fact clearly when he said, “…on every
voyage of exploration I have been able to bring back a
cargo of indisputable truths, that all the remedies
necessary to health exist in the human body.”3

This general statement became invaluable for the

Anne Wales DO FCA Annual Conference Louisville, teaching of skills to be used by physicians when
Kentucky 1974 addressing themselves to the clinical problems of their
patients only when he told us what an osteopath is to do.
Charles Darwin closed The Origin of Species with this
“An osteopath is only a human engineer, who should
sentence:
understand all the laws governing his engine and thereby
master disease.”4 The experience of the operator is
“There is grandeur in this view of life, with its several
expressed again when Dr. Still says, “There is no part
powers, having been originally breathed by the Creator
which if affected by disease does not present a
into a few forms or into one; and that, whilst this planet
philosophical question to be answered by an engineer and
has gone cycling on according to the fixed law of gravity,
not by an imitator or a masseur.”5
from so simple a beginning endless forms most beautiful
and most wonderful have been and are being evolved.”1
I can testify to this living truth for it is the way I have
traveled my professional life and it is on this way that I
Stephen Jay Gould chose the phrase This View of Life for
gradually came to the view I value so highly. The territory
the title of his column in Natural History magazine. In the
to be explored and understood lies in the bodies of my
June-July (1974) issue he analyzes a misunderstanding
patients. The light that reveals the view came gradually
that he calls Darwin’s Dilemma. It seems that Darwin
from those philosophical questions and the slow
spoke of “descent with modification” and shunned
accumulation of answers. They began to add up after I
evolution as a description of his theory. Mr. Gould traces
studied with Dr. Sutherland and learned to include the
the story of how “this view of life” came to be called
anatomy-physiology of the cranium and face in my work
evolution. It is an interesting exercise in etymological
with the body as a whole.
detection, as he says.2
At the beginning, that is when I was confronted by my
It is also distressing to realize that had Darwin’s
first patient in the college clinic fifty years ago, I knew that
insistence, “that organic change led only to increasing
I didn’t know what to do because I didn’t know anything
adaptation between organisms and their environment and
about the practice of Osteopathy. In fact, I had only an
not to an abstract ideal of progress defined by structural
introduction to biology and all that follows from it. I
complexity” prevailed, much confusion between scientists
continue to be fascinated by all the subjects that go with
and laymen would not have occurred. At the end Mr.
the study of life and that includes the modern texts of
Gould regrets that scientists contributed to a fundamental
anatomy and physiology. This is the necessary foundation
misunderstanding by selecting a vernacular word meaning
for an engineer of the living body. One has to know the
progress as a name for “this view of life.”
engine and how it works in order to be able to study any
problem it may have. It is a great help when considering
I want to talk about another view of life that I value with
problems to realize that the remedies exist within the
deep appreciation as a reward for the past fifty years spent
patient.
in the practice of Osteopathy. This view has unfolded for

14 The Cranial Letter, November 2016, Volume 69, Number 4


But back to the beginning, my problem lay in the fact that
Dr. Styles had told me to simply get acquainted with knees,
not to try to do anything to them. My patient’s problem
was painful, swollen knees, so bad that she had given up
attending church services. She was a fairly heavy woman
in her fifties, pleasant and relaxed. With her seated on the
table and me on a stool I confronted the knees I was to get
acquainted with. The question was not philosophical, it
was practical. How do you go about getting acquainted
with knees, especially knees that looked like those!
One can look for only so long. Even when all that I knew
of knees was racing through my wits fast enough to addle
them, I was remembering that Dr. Platt had taught in the
class on principles that an osteopath starts with his view of
the normal. I was also remembering how Dr. Halladay had
said that the purpose of the work in anatomy lab was to
learn to know what is under our hands wherever we place
them.
Since it seemed time to do something besides look with
my eyes I put my hands around one knee and felt its
swollen condition. At first I could feel nothing else. How
to feel a joint through such a condition eluded me but just
to keep some semblance of being in command of the
situation, I put my hands around the other knee and felt
the same swollen condition. There was, however, a
difference in the feel of the two joints as compared with
each other. This intrigued me and truly put my mind on
the track, for there was a question to answer. What was
this difference that I had noted? The question moved me
to try to move those joints by quietly turning the tibias and
comparing the two responses to this action. Of course I
was scared I might hurt her, for I did not know whether
this constituted treatment. I watched her face as I
repeated the action and decided that I was not treating
because nothing happened. Naturally I did not know what
she thought.
When she returned three days later I was truly surprised
to hear her say that she felt much better. Also glad. The
real impact came when I repeated my efforts to get
acquainted with her knees. They were in an entirely
different state of swollen tension. To this day I have no
name for such changes, but they occur regularly. As I
learned through the course of the dozen visits that
consisted only of my efforts to learn what knees felt like,
this change was indeed an improvement, for it was
followed by further changes that finally led to comfort and
function for her. I did not see her again. I could not figure
out what I had done or what had happened.
Time went on and experiences were many. An osteopath
has few dull days, for no two patients are alike and no one
patient is exactly the same twice. One’s duties and
responsibilities as a physician in general practice require
many skills other than one’s skills as an osteopath and all
together one grows in understanding as well as in
experience. In retrospect there must have been some
significance in the fact that I saved the Northwest Bulletin
The Cranial Letter, November 2016, Volume 69, Number 4 15
for November 1931 but I do not remember what it was. It
contained Skull Notions V by one who called himself “Blunt
Bone Bill.”6
When Dr. Sutherland came to that place in his lectures to
the class in New York in April 1944, where he spoke of the
possibility of ringing the ethmoid bell from the sacrum it
seemed that I had heard the thought before. Then I
realized who “Blunt Bone Bill” was. After we had settled
down a bit from that momentous week, I searched for and
found that Northwest Bulletin.
The following quotation from that article shows how
much can be said in one paragraph when the speaker has
the whole view in mind, “The ethmoid bone with its
turbinates provides thought for extended study, to say
nothing of others in relation to it. The ethmoid breathes.
A little bone, yet it has articular relationship with thirteen
others. Why? It might be the ‘bell-sheep’ of the entire
flock of cranial and facial bones, leading them in
membranous articular mobility. It could be the ‘air-
propeller’ that lifts the sphenoid. The sphenoid bone with
its greater and lesser wings could be called the ‘airship’!
Its front end ascends during expiration and makes a nose
dive in association with inspiration. In relation therewith
superior and middle turbinates of the ethmoid swing bell-
like anteriorly as the ‘ship’ ascends and posteriorly during
the ‘nose-dive.’ In the meantime, the falx cerebri, acting in
the capacity of the ‘bell rope’ through its attachment at the
crista galli, functionally cooperates in the bell-like
movement. As the front end ascends, the rear end
descends, thus assisting in the undulatory-rotary articular
mobility of the petrous-basilar articulation. The tentorium
cerebelli, having attachment to the clinoid processes
provides a functional cooperation with the falx cerebri.”7
Before we actually studied with Dr. Sutherland, we had
heard him speak before the Eastern Osteopathic
Association the preceding year. And before that there had
been some preparation in our minds.
In 1937 Dr. Perrin T. Wilson was program chairman for
the New England Osteopathic Association. He had
arranged for Dr. Charlotte Weaver to give two lectures. I
was so enthralled with the view of cranial bones as three
modified vertebrae and with the consideration of the dura
matter as an interosseous membrane that I practically
devoured the articles that she had published in the Journal
Of The American Osteopathic Association in March, April
and May 1936.8 Later, my husband, Chester L. Handy, DO,
and I read all of the papers published by Dr. Weaver and
her associates, aloud, twice. These were very stimulating
in several respects and certainly enlarged and deepened
our views of physiological mechanisms. But for us they led
to no practical clinical use.
This background was significant and helpful when we
listened to Dr. Sutherland in New York in 1943. Those
lectures included a picture of the human face located on
the other side of the cranial base from that upon which the
brain rests upon its water beds. The illustrations of the
sphenoid, especially, that had been prepared by Mrs.
Sutherland not only showed the key to this but also drove
the point home to us that we were too ignorant of the
anatomy of the region to appreciate all that Dr. Sutherland
was saying. We intended to do some serious studying of
anatomical texts in anticipation of the day when we could
study with him but, of course, we never got around to it.
That is the reason we accepted an invitation from Doctors
Howard and Rebecca Lippincott to attend their study
group in November 1944. The opportunity to “hit the
books” with a friendly group of like-minded colleagues was
invaluable to say nothing of the organized practice
sessions. We had been practicing on each other and
continued to do so but our thinking was clarified
considerably by participating in the practice groups at
Moorestown. We also benefited by having our own heads
treated. There is no doubt that we learned more by
traveling to the Lippincott’s once a month for five years
than we would actually have accomplished by studying at
home. We knew that much about ourselves. But it is also a
fact that we might have done as much on our own with
what Dr. Sutherland gave us in lectures from Monday
morning to Saturday noon the first week in April 1944.
The concept and the data were there in our minds when
we went home.
Two things happened that moved us along the way we
had determined to follow. The first was that the Drs.
Lippincott encouraged us to start the New England Cranial
Study Group and the second was that we each attended an
additional class given by Dr. Sutherland with an associate
faculty at the Des Moines college. Both the effort to share
what we had received and hearing Dr. Sutherland again
sharpened our grasp of the view of the Primary
Respiratory Mechanism as a living process that goes on all
the time in living human beings.
Incidentally, something was going on every day in our
offices between these events. We were seeing problems in
our patients’ bodies that we had not seen before. And we
were treating according to the principles that we were
learning. It was an amazing experience to realize that even
as the new way revealed its power for success there was
nothing about it that denied the successes of the old way.
In the spring of 1947, after the review of the anatomy and
mechanics of the cranio-sacral mechanism that I had just
been through, I suddenly realized that I didn’t know what
kept it running. So I asked Dr. Sutherland what came next.
And he asked me why I expected any “next”. I could not
express myself better than to say, “Well, there has to be
more.” The next thing I knew a whole group of us had
changed plans and accepted invitation from the
Sutherlands to go to St. Peter, Minnesota to study some
more. When we all got settled in the Nicollet Hotel and
went to Dr. Sutherland’s office he said that we had had
enough of the cranium for a while so we would talk about
the rest of the body. Those days were so full of new views
of what I thought I was familiar with, that I do not
remember how long we were there or even precisely what
I learned. But it all went on working in my mind.
16 The Cranial Letter, November 2016, Volume 69, Number 4
The results of that session are to be found in the 1949
Year Book of the American Academy of Osteopathy, thanks
to Dr. Howard Lippincott’s work as a photographer and Dr.
Sutherland’s pleasure in the project. It is my guess that
another result followed from that visit to St. Peter. For
after that Dr. Sutherland talked carefully about his ideas
regarding the fluctuation of the cerebrospinal fluid and the
“fluid drive” in the body as a whole. He also showed us
how little mechanical force is needed for the to and fro
movement of the membranous articular mechanism. Yet it
took some time for me to see the necessary and sufficient
function of the automatic shifting suspended fulcrum in
the operation of the reciprocal tension membrane as it
runs the cranial articular mechanism.
I think that Dr. Sutherland had decided that the group of
us whom he had been teaching for some time had reached
the place in our understanding where we were ready for a
look at a larger view that he had not previously exposed us
to. In any event I appreciated the answers I received to my
questions for they continue to stir my thinking so as to
disclose more views of anatomical physiological
mechanisms as they appear in practice.
It was a tremendous experience for me when I began to
feel the action within my patients’ bodies. It was also very
difficult to change my working habits so that I could.
Actually, it was an idea that forced me to accomplish the
change. Dr. Sutherland said many times in many places
that there is no force than can be safely applied to the
living body from the outside that is as powerful for the
correction of lesions as the forces inherent within the
body. I kept wondering about the forces within. There is
the “trend toward the normal” that I had always heard
about but never came to grips with. Finally it dawned, the
key lies in the nature of the mechanisms. This was when I
began to look at the terms ligamentous articular strains
and membranous articular strains and saw that they were
Dr. Sutherland’s terms for the osteopathic lesion. This
view helped to connect my existing concept of what I was
doing with the new concept of positioning joints so that
the reciprocal tension in the mechanism could operate to
change the relationship of the parts. Then I could succeed
in stopping my hands from the old ways of doing and teach
them to learn some new ways. After that I began to feel
what was going on within.
The problem ever since has been to interpret and
understand what I feel going on within. Then there is the
problem of how to put it into words. The mechanical
principles of reciprocal tension mechanisms are clear
enough. The following description from an article by
Walter J. Albersheim, ScD says it well, “The Latin root
vibra means a slender, whip-like twig; so vibration means
a whipping, oscillating motion. We may study its character
by its classical prototype of a swinging pendulum. The
pendulum is set into motion by an initial supply of energy,
such as lifting of its bob to a maximum height or
elongation. This energy storage can last a long time; even
if seemingly consumed by friction, it has only been
transformed into other expressions. But let us look at one
period by itself. At the beginning of each swing, all motion
stops for an instant before it reverses its direction. At this
point, all energy expresses as polar tension, as an
overcoming of the pull of gravity. Then, in mid-swing,
having reached its lowest point, the pendulum has
transformed all that polar or potential energy into motion-
kinetic energy, momentum or action.”9
Once I grasped the universality of reciprocal tension
operations in the various skeletal mechanisms of the living
body I became more adept at positioning the parts so as to
produce ease followed by an active release of the strain.
And once I became more adept at finding the still point of
balance in the situation, I had some experience in
observing ligaments and membranes moving bones at
joints. This adds up to getting the self-correcting powers
within the patient’s body to do the work while the
operator watches them in action. This is the view of the
magnitude of the science of osteopathy that I find so
exciting. This is the potency within as it applies to the self-
regulating, self-correcting and self-healing powers that we
all know are there.
Dr. Sutherland emphasized that the cranial concept came
from within the science of osteopathy as expressed by Dr.
Still. He was fond of quoting Dr. Asa Willard as follows,
“Along in 1874, after years of independent thinking, there
came to Dr. A.T. Still, a conception of the basic principles of
a great truth.”10
In the paper called The Science of Osteopathy, that he
presented in 1952, Dr. Sutherland wanted to convey his
thought of the practice of osteopathy as a non-incisive
surgical art greater than mere structural manipulation. He
said that Dr. Still taught ways of working that were aimed
at establishing free circulation of fluids everywhere,
including the cranium and face. He said further, “I stress
the fact that his contact on the osseous parts of the
mechanism was gentle and firm. The fingers should alight
like the digits of a bird, gently on a twig and then gradually
securing firm contact: so accomplished as not to injure the
bark of the twig. This is not what is commonly known as
“manipulative therapy”, but a demonstration of our theme:
non-incisive surgery.”11
This larger view that I am celebrating is not mine alone.
It is shared by many and I believe that it has always been
there for all osteopaths to see when they have followed the
trail blazed by Dr. Still far enough. After that the view
itself takes over and working with it in mind enriches the
rest of the way. Dr. Rollin Becker has expressed it as
follows in an unpublished paper called A Concept FOR
HEALTH, TRAUMA AND DISEASE, “LIFE is manifested
through space and time which is the outcome of movement
to demonstrate as body physiological functioning. Life
cannot be defined. It can be described. Both time and
space are the outcome of movement, the characteristic of
The Cranial Letter, November 2016, Volume 69, Number 4 17
life, from its highest spiritual manifestations down to the
simplest physical phenomena. Life includes Stillness and
space and time: Movement to demonstrate as body
physiological functioning.”12
His application of this view to achieve balance in
physiological functioning in anatomical-physiological
mechanisms is discussed in the following, “Reciprocal
balance techniques require that the physician have a
working philosophy and physiological knowledge of the
anatomical mechanisms of the body physiology of the
patient. Reciprocal balance techniques in body physiology
evaluate and create health…and they diagnose and treat to
correct trauma and disease…Basically, the physician is
trained in anatomy, physiology, pathology and all other
allied sciences to clinically evaluate health and to do
something for the patient with medicine, surgery, and
other modalities to treat trauma and disease. Reciprocal
balance techniques require that the physician go another
step deeper into the understanding of the body physiology
of the patient by working with and through the anatomical
physiological mechanisms of the patient as the motive
power to evaluate and create health and to diagnose and
correct existing trauma and disease.”13
There is no more to say after this swift review of what I
have learned about the living human body except that I
hope the day will come when all physicians will be
working with this view in mind as they undertake to serve
suffering humanity.
References
1 Darwin C, The Origin of Species, The New American
Library, New York, 1958.
2 Gould SJ, This View of Life, Natural History, Vol. 83, No. 6
June-July 1974, American Museum of Natural History, New
York, pp 16-22.
3 Still AT, Autobiography, Kirksville, Missouri, 1897, p. 100.
4 Ibid., p. 312.
5 Still AT, Research and Practices, Kirksville, Missouri,
1910, p. 48.
6 Sutherland WG, Contributions of Thought, Collected
Writings, ed Wales AL, Sutherland Cranial Teaching
Foundation, 1967, p. 41,
7 Ibid.
8 Weaver C, Cranial Vertebrae, JAOA March, April, May,
American Osteopathic Association, 1936.
9 Albersheim WJ, The Trinity of Power, Rosicrucian Digest,
Vol. 52, No. 5, San Jose, California, 1974, pp. 10,11.
10 Sutherland WG, The Cranial Bowl, Mankato, Minnesota,
1939, p. 11.
11 Op. Cit., p. 1985
12 Becker RE, A Concept for Health, Trauma and Disease
and Reciprocal Balance Technique, Unpublished paper,
May 1974, p. 2.
13 Ibid., p. 4.
18 The Cranial Letter, November 2016, Volume 69, Number 4
 Applications for Membership
(August 14, 2016 – October 15, 2016)

Regular Members*
Tony Bianco, DO, Columbus, OH
Adam Colton DO. Franklin, MI
Rebekah Crawford DO. Portsmouth, OH
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Melchiorra M. Mangiaracina DO,
Scottsdale, AZ
Kelly McCarter DO, Orlando, FL
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Erika Pope DO, Mt. Vernon, WA
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International Members
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Sylvie Mor DDS, France
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Jonathan Burgei, OU/HCOM 2018
Justin Deagnon, TUCOM 2020
Erin DePrekel, PNWU 2017
Danielle Emmet, TUCOM 2019
Jason Faucheux, NSU/COM 2017
Andrea Freska, WVSOM 2018
Stephen Fung, TOURO-NY 2019
Christopher Gibson, OU/HCOM 2018
Logan Gray, OU/HCOM 2018
Matthew Hagen, OU/HCOM 2018
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Destiny Jamison, OU/HCOM 2018
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Kris Schwacha, OU/HCOM 2018
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Linda Stewart, TUCOM 2019
Stephen Toth, OU/HCOM 2018
Cindy Tran, OU/HCOM 2018
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Reinstatement Members
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*If no written objection is received
within 30 days of publication individuals
who have made application for Regular
Membership will be accepted as Regular
Members.

Looking for an Osteopathically trained
physician with good hands on treatment
experience (particularly with children) and
interest in CME in OMT, to join a busy
pediatric and adult practice in Santa Monica,
California. For more information please see
my website: kathryngillmd.com. Please send
your resume and letter to:
Kathryn Gill, M.D.
1821 Wilshire Blvd., Suite 306
Santa Monica, CA 90403
or
E-mail: k.gillgopian@gmail.com
(310)576-2503
Free Faculty Development and Clinician Offering Of An Eye
OMT Tutorial To Accompany the Cranial Academy Current
Article Series, An Osteopathic Approach to Ophthalmic and
Optometric Disorders
I have been working with and building upon the
teachings of various traditional osteopaths since the mid
1980’s to synthesize a concise sequential way to approach eye
disease in osteopathic practice. It would be a privilege to be
able to share this material, and these techniques with you, for
the benefit of your patients, as they were shared with me, by
Drs. Jealous, Frymann, Wales and Blood, for instance. I am
reaching out to private practicing traditional osteopaths in the
tri state area, however, no one qualified (DO, MD) will be
excluded. An intro or basic cranial course is a good
prerequisite and recommended. This is scheduled for
December 6, 2016, from 1 to 3 pm in the OMT lab. Lunch will
be cordially provided to participating private clinicians and is
scheduled for noon.
Contact Dr. Abu-Sbaih if you plan on attending,
(rabubusbai@nyit.edu or 516 686 1312) by Nov. 4, 2016. In
addition to local manipulating osteopaths and NYITCOM
faculty, OMT residents will be welcome as well. I will strive to
ensure that table partnering is commensurate with skill or
experience.
I am confident you will find this material clinically
relevant and available for immediate use, for a myriad of visual
system pathology, although no CME has been worked out for
this academic development event.
Bring any personal eyeglasses or contacts and their
containers with you in case we explore osteopathic optical
screening. Feel free to forward to other qualified DO/MD
attendings, interns, residents or qualified students.

The Cranial Letter, November 2016, Volume 69, Number 4 19

 State Society Coming Event Foundation Corner
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December 1, 2016 research programs. Donations are tax deductible as charitable
8 hours category 1-A credit anticipated, contributions for federal income purposes to the extent permitted
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20 The Cranial Letter, November 2016, Volume 69, Number 4

The Cranial Letter, November 2016, Volume 69, Number 4 21
 An Osteopathic Odyssey
By James Jealous D.O.

This book is a series of commentaries from almost

50 years of practicing Osteopathy using the
Biodynamic Methodology. It has daily comments
and some practical tasks that can be used to
support skill development and Osteopathic
thinking. The Book is randomly organized to
eliminate rational interpretation and help ones
understanding as a whole.

To order this book please go to

www.jamesjealous.com

22 The Cranial Letter, November 2016, Volume 69, Number 4

The Cranial Letter, November 2016, Volume 69, Number 4 23
The Osteopathic Cranial Academy
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Coming Events Osteopathic Cranial Academy
Proficiency Examination
February 11-15, 2017 Midwinter Introductory Course in
Osteopathy in the Cranial Field
Thursday, June 15, 2017
Course Director: Zina Pelkey DO FCA
Hyatt Regency Atlanta Perimeter at Villa Christina Hyatt Regency Nicollet Mall
Atlanta, Georgia Minneapolis, Minnesota
February 17-19, 2017 The Biomechanics of Delight:
Deepening Our Understanding of Osteopathy as
Medicine Application Fee: $100.00
Course Director: Judith Lewis DO FCA Testing Fee $150.00
Hyatt Regency Atlanta Perimeter at Villa Christina
Atlanta, Georgia
April 21-23, 2017 Teachings of Robert Fulford DO FCA II Contact The Osteopathic Cranial
Course Director: Paula Eschtruth DO FCA and Academy for prerequisites and
E. Sarah Saxton DO
Portland, Oregon registration information.
June 10-14, 2017 June Introductory Course in Osteopathy in
the Cranial Field Application Deadline
Course Director: Richard Smith DO
Hyatt Regency Nicollet Mall, Minneapolis, Minnesota November 30, 2016
June 15, 2017 Proficiency Exam
Hyatt Regency Nicollet Mall, Minneapolis, Minnesota The Osteopathic Cranial Academy
June 16, 2017 Annual Membership Meeting
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June 15-18, 2017 Annual Conference Indianapolis, IN 46240
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Conference Directors: Hugh Ettlinger DO FAAO FCA and FAX: (317) 580-9299
Zina Pelkey DO FCA
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