Dr. Rudolph Virchow (1821-1902) wrote his major work, Cellular Pathologie, in 1858.
"Virtually all forms of tissue injury start with molecular or structural alterations in cells, a concept first put forth in the 19th century by Rudolph Virchow, known as the father of modern pathology. We therefore begin our consideration of pathology with the study of the origins, molecular mechanisms, and structural changes of cell injury." ([Emphasis in original] 4th edition, 1989, page 2)
Dr. Virchow derived his understanding of the cell from the work of Theodor Schwann. In his important but largely ignored 1916 book, Form and Function, E.S. Russell captures the essence of Schwann's theory: "Each cell was itself (for Schwann and Virchow) an organism, and its life and activities were to some extent independent of the lives and activities of all the other cells. The multicellular organism was a colony of unicellular organisms, and its life was the sum of the lives of its constituent elements."(page 180)
Dr. Claude Bernard is generally recognized as the leading physiologist of the 19th century. He, along with Virchow, is recognized as a "founding father" of allopathic medicine because he initiated the proposition that advances in medicine must be based upon animal experimentation.
However, Dr. Bernard strongly disagreed with the "Schwann-Virchow" theory of disease and proposed a paradigm in which disease was said to arise as a result of dysfunction within the milieu intérieur (internal environment). His paradigm has been virtually ignored by allopathic medicine. Of course, Louis Pasteur was also a major contributor to "modern" medicine. Dr. Pasteur agreed with Virchow early in his career, but shifted to Bernard's side of the debate toward career's end.
Dr. Bernard delivered a series of 21 lectures in 1860 at the College of France, which were translated into English and published in the 1861 editions of The Medical Times and Gazette, A Journal of Medical Science, Literature, Criticism, and News, published by John Churchill of London, England. This journal was widely distributed in the United States and is still available for review in the archives at UCLA. In the last lecture in this series, Bernard summarized and reiterated his basic theory.
Pierre Louis Gaucher-Peslhebe,DC, suggests in his book Chiropractic: Early Concepts in Their Historical Settings (1993) that D.D. Palmer got his idea about the importance of neural regulation from Dr. Bernard. Professor Joseph Keating, in his articles in Dynamic Chiropractic, has demonstrated that D.D. clearly knew what was going on within medicine and physiology during the latter part of the 19th century. It would behoove the reader to look at Bernard's actual words, available to D.D. Palmer as he defined the basic chiropractic principles:
Harmony and Tone
Bernard was a disciple of Magendie, the great 19th century physiologist. It seems likely that Bernard derived his concept of the importance of the "harmonious" relationship between the parts of the "living frame" from Magendie. It also appears likely that Magendie derived this concept in part from Chinese medicine. Magendie started practicing "electroacupunture" as early as 1835.1 Wherever it came from, the concept of "harmony/tone/balance" (and self-regulation) is critically important, and obviously a founding principle of chiropractic and acupuncture.
We must acknowledge, however, that Bernard did not speak of only the nervous system as a factor in the body's ability to self-regulate. He also pointed to the importance of the "local circulation." Indeed, that aspect has been a focus of attention for the osteopaths and also leading 20th- century physiologists. Guyton, in the most recent edition of his work, states:
"In the extracellular fluid are the ions and nutrients needed by the cells for maintenance of cellular life. Therefore, all cells live in essentially the same environment, the extracellular fluid, for which reason the extracellular fluid is called the internal environment of the body, or the milieu intérieur, a term introduced more than 100 years ago by the great 19th-century French physiologist Claude Bernard." ([Emphasis in original] Guyton, Hall, Textbook of Medical Physiology, 10th edition 2000, page 2)
Guyton does a disservice to the work of Bernard by ignoring Bernard's emphasis on the nervous system and the concept of "self-regulation." It is becoming clear that the "internal environment" is a very complex structure. It serves a far greater purpose than merely that of a transportation system. (Of course, it does transport and house nutrients; hormones; neuropeptides; immune cells; etc.) We will demonstrate in a future article that much more than mere chemistry and transportation is involved. For now, let's look at some developments relative to the concept of the body's innate capacity for self-regulation and at its capacity for harmonious interaction within the internal environment.2
Bennett's Functional Unit
Terrence Bennett was a chiropractor practicing in California at the time of the adoption of the Chiropractic Act of 1922. At an early date in his career he gave an expanded definition of the concept of "self-regulation" that is difficult to improve upon even at this time. After discussing the importance of the nervous system, Bennett added:
"...so the arteriole, the capillary, the tissue space, the cell, the lymph capillary, which also lies in this same area, and we have a functional unit which is common to all tissue in the body." (Emphasis added)3
It is important to note that Bennett includes the cell within the "functional unit." Dr. Alfred Pischinger, of the University of Vienna Medical School, came up with a similar concept in the 1940s, but he did not include the cell within his definition of the body's regulatory mechanism. The emerging evidence about the body's innate self-regulatory capacity, which we will address in a future article, makes it clear that organ cells should be considered as part of the "internal environment - self-regulation paradigm."
Pischinger's "Regulatory Matrix"
Dr. Pischinger was a histologist who began work on defining the components of the extracellular compartment as early as 1945. His work has become the basis for a whole field of what is called "functional medicine" in Europe. Pischinger called the extracellular compartment the extracellular matrix because of both its complexity, and because of the interactive relationships of its component parts. He went so far as to flatly state:
"Organic diseases originate in dysfunctions of this system (the 'matrix') and its connections throughout the organism."4
He does not, however, include the cell as part of the functional unit; in that regard, he falls short of Bennett's definition of the "functional unit." Bennett is closer to the truth, as will also be demonstrated in a future article.
Flexner and Virchow
We will assume that our readers have heard of the Flexner report of 1910 and its impact on medical education in the United States. What you might not be aware of is its direct impact on the issues related to disease causation, and the Virchow-Bernard-Palmer-Bennett debate, through its utilization in the accreditation process for "medical" schools and legislation related to "medical" practice. Simply put, the debate over theories of disease causation was usurped by Flexner, who was neither a biologist nor a physician.
Flexner, in his report, gives a detailed description of what he believes should be the basis for the study and practice of medicine. On page 65 of a special republished version of his report (1990), he establishes Virchow's theory as the only acceptable approach to the understanding of disease. Flexner's report served as the foundation for the establishment of the current "medical-drug cartel" and the legislative and judicial pronouncements supporting that complex. Obviously, the answer to theories of disease should be derived from clinical and laboratory investigations, not by, in effect, legislative/judicial/accreditation fiat.
Robbins Revisited
At the start of this article, we quoted Robbins' view of the concept of "cellular pathology" from 1989. A new concept was added in the 1994 edition of Robbins (page 2). The basic concept of pathology is now stated as follows:
"Virtually all forms of tissue injury start with molecular or structural alterations in cells, a concept first put forth in the 19th century by Rudolph Virchow, known as the father of modern pathology. We therefore begin our consideration of pathology with the study of the origins, molecular mechanisms, and structural changes of cell injury. Yet different cells in tissues constantly interact with each other, and an elaborate system of extracellular matrix is necessary for the integrity of organs. Cell-cell and cell-matrix interactions contribute significantly to the response to injury, leading collectively to tissue and organ injury, which are as important as cell injury in defining the morphologic and clinical pattern of disease." (Emphasis in original.)
The recognition of the importance of the "extracellular matrix" is a step forward, but something is still missing from this allopathic theory of disease causation. Notice that the "interactions" between the cell-cell and cell-matrix are presented as a one-way street. The matrix-cell interaction, or regulatory function, is simply ignored. We will demonstrate in our future articles that this is a critical error.
It is understandable that the allopathic community would have difficulty accepting the concept of the extracellular regulatory function, as it has been captives of Virchow's cellular theory of disease for so long. In addition, its preoccupation has been with chemistry and drug therapy. This has, until recently, been preoccupied with the cell wall and receptor cites. Of course, it has now gone "down" to the gene level. The allopathic community cannot be expected to fully appreciate the implication of what we are calling the "internal environment - self-regulation paradigm."
Palmer and the 21st Century
The "internal environment - self-regulation paradigm" must be developed and refined by those following the Bernard-Palmer-Bennett-Pischinger or acupuncture theories. The question for chiropractors then becomes whether they will "step up to the plate" and acknowledge that elements of such a paradigm cannot be fixed in stone, based upon late 19th and early 20th-century knowledge. Obviously, Bernard and the early founders of chiropractic were operating with a limited knowledge of histology, chemistry and physics, and within a changing philosophical/religious environment. Chiropractors, and more particularly the chiropractic colleges, cannot ignore the advances in scientific knowledge that have taken place since the founding of chiropractic.
The chiropractic principle that the body has an innate capacity for self-regulation is clearly supported by recent advances in our understanding of basic physiology. But the constituent elements and applications of this paradigm are in their infancy, compared to the paradigm that has been developed due to the funding available to the "medical-drug cartel." Chiropractors and other non-allopathic practitioners must incorporate new scientific knowledge as it arises.
Chiropractors, acupuncturists and others who have not been blindsided by the cellular theory of disease and by drug therapy, who are willing to work in an expanding knowledge base, need to speak up and demand equal treatment before the law, and equal access to the governmental research funding stream. Without such action, the full development of the concept of the "internal environment - self-regulation paradigm" will continue to play second fiddle to the allopathic model of warring against disease and nature.
In our next article, we will discuss some of the approaches to evaluation and treatment within the "internal environment - self regulation paradigm." In the article after that, we will detail some of the emerging scientific evidence supporting this paradigm. Thereafter, we will look again at the 19th century battles over the philosophical ramifications of the ideas of not only "self-regulation," but also "self-organization."
D.D. claimed that the "power that makes the body, heals the body." What does that mean? Was that an idea that was in play during the 19th century? What happened to that premise in mainstream biology and medicine? We leave you with these questions for now.
- Ho, Popp, and Warnke, Bioelectro-dynamics and Biocommunication, (1994), p. 7. By mid-nineteenth century, electro acupuncture had spread to Italy and Germany. Electroacupuncture was introduced into China from the West in 1958. (Id.)
- The issue goes deeper than just "self-regulation." It also raises the question of morphogenesis. We will return to the philosophical aspects of this subject in a subsequent article.
- Martin. Dynamics of correction of abnormal function. The Terrence J. Bennett Lectures (1977), p. 6.
- Heine (ed.). Matrix and matrix regulation. Basis for a Holistic Theory of Medicine (1991), p.21.
David Prescott, MA,JD,DC,FIAMA
Silverado, California
Hon. Edwin Grauke,JD,DC
Lakewood, Colorado