From the Editor's foreword:
This book presents a portion of the work done by Viola M. Frymann, DO, in her service to humanity. Through her direct contact with patients, parents, students, and colleagues, Dr. Frymann has guided, encouraged, inspired, and challenged with deep and telling effect which many be only sensed in these papers. These papers are some of the products of a truly remarkable career in osteopathic medicine, spanning over fifty years, and still going. In these papers, we see the manifestations of her life as a scientist, teacher, physician-healer, philosopher, mother, and steward of the profession. Herein presented is a broad, but pure, perspective on Osteopathy.
Dr. Hollis H. King, DO, PhD, FAAO, FCA is a graduate of Texas College of Osteopathic Medicine, Fort Worth, TX . He is board certified in Family Medicine/OMT from the American Osteopathic Board of Family Physicians and certified with Special Proficiency in Osteopathic Manipulative Medicine from the American Osteopathic Board of Neuromusculoskeletal Medicine. He is a Founding Diplomate of the American Board of Holistic and Integrative Medicine. His postdoctoral training was at Dallas Memorial Hospital, Dallas, TX. His internship was at the VA Hospital & Univ. of Kentucky Medical School, Lexington, KY. His Ph.D. in Clinical Psychology is from Trinity University, San Antonio, TX. He is a Fellow of and Past-President of the American Academy of Osteopathy. He is a Fellow of the Osteopathic Cranial Academy. Dr. King is currently a Clinical Professor of Family Medicine at the University of California San Diego School of Medicine. He also has a private practice at Osteopathic Center San Diego. His memberships include: AOA, AAO, OCA.
Table of Contents
Editor's Foreword: Hollis Heaton King, DO, PhD ...................................................................................... ix
Acknowledgements .………………………................................................................................................. xi
Preface …..............…..…….......…………................................................................................................ xiii
Palpation and beyond ……………………………………..……………...…………………………………….. xv
I. Clinical Research
1. Relation of disturbances of craniosacral mechanism to symptomatology of the newborn:
Study of 1250 infants ........................................................................................................................... 3
2. A study of the rhythmic motions of the living cranium ......................................................................... 17
3. Leaming difficulties of children viewed in the light of the osteopathic concept ................................... 31
4. Testing osteopathic medical concepts in a real-life setting: Editorial by Michael M. Patterson, PhD .. 43
5. Effects of osteopathic medical management on neurologic development in children ......................... 44
II. Applications of Osteopathic Principles in Clinical Practice
6. Palpation: Its study in the workshop ................................................................................................... 59
7. Fascial release techniques ................................................................................................................. 72
8. The osteopathic approach to cardiac and pulmonary problems ......................................................... 83
9. The role of the osteopathic lesion in cardiac pathology ...................................................................... 89
10. The role of the osteopathic lesion in functional and organic renal pathology ................................... 93
11. Cerebral dysfunction: Prevention and treatment in light of the osteopathic concept ........................ 97
12. The osteopathic approach to the allergic patient ............................................................................ 104
13. Diagnosis and treatment of otitis media in children ........................................................................ 110
14. The unique and significant contribution to the health care of the U.S. Air Force potentially
available through osteopathic palpatory diagnosis and treatment ................................................. 112
III. Osteopathy in the Cranial Field: Structure and Function
15. The primary respiratory mechanism ............................................................................................... 117
16. The Cerebrospinal fluid motion ....................................................................................................... 121
17. Know your anatomy: Cranial nerves ............................................................................................... 125
18. The core-link and the three diaphragms: A unit for respiratory function ......................................... 134
19. Perceptive palpation = diagnosis .................................................................................................... 141
20. The expanding osteopathic concept (1960) ................................................................................... 144
21. The development of the expanding osteopathic concept ............................................................... 155
22. The expanding osteopathic concept: Expansion to the cranial field ................................................ 158
23. Sutherland passes on the torch …………………………………………….……..…………………….. 164
24. Manipulative treatment of sinus infections ……………………………………………………………… 170
25. Cranial osteopathy and its role in disorders of the temporomandibular joint ……………………….. 174
26. Why does the orthodontist need osteopathy in the cranial field? ……………………………………. 182
27. Lateral strains of the sphenobasilar synchondrosis (symphysis) ……………………………………. 184
IV. Osteopathy’s Promise to Children
28. The why, the when, and the how of the osteopathic manipulation of infants and children ….....… 189
29. The trauma of birth …………………………………..……….…..………….....….…………………….. 193
30. Birth trauma: The most common cause of development delays …………………....…….…..…….. 200
31. Learning disabilities in childhood ……………………………………………………….…….………… 201
32. Explorations into posture and body mechanics ……………………………………………..………… 206
V. For Families and Parents
33. Interview with Viola M. Fryman by Allan Jacklicy …………...………………………………………… 211
34. Looking to the future: Plan for the Osteopathic Center for Children ……………………….….……. 216
35. Preamble to osteopathy for parents ……………………………………………….…………………… 219
36. Osteopathy for parents …………………………………………..……………….……………..……… 220
37. Steps you can take at home ………………………………………………………......……...………… 227
38. Music therapy ……………………….…………………………...…………………………………..…… 233
39. Prevention ……………………..………………………………………………………………………….. 238
VI. Invited Lectures to the Osteopathic Profession
40. The law of mind, matter and motion: Scott Memorial Lecture, 1972 …………......……..………… 243
41. Motion – the difference between life and death: Thomas L. Northup Lecture, 1977 ……..…..….. 251
42. Can the concept stand the test of time? Sutherland Memorial Lecture, 1963 ………..……....….. 257
43. Osteopathy, the bringer of peace, harmony, healing: Sutherland Memorial Lecture, 1995 ……... 264
VII. Osteopathic Medical Philosophy
44. Osteopathy, disease, health ………………………………………………..……………..…………….. 271
45. What’s in a name? ……………………………………………………………………………………….. 276
46. The philosophy of osteopathy …………………………………………………………………………… 280
47. Philosophy in action ……………………………………..………………………………………………. 286
48. The physician’s responsibility to man ………………………………………………………………….. 293
49. Unique osteopathic aspects of care ………………………………………………………………….… 300
VIII. Contribution to Integrative Medicine and Applications of Principles of Healing
50. A scientific study of prayer and healing by the power of the Holy Spirit ………………….……...… 305
51. The expanding osteopathic concept (1980) …………………………………………………..……… 312
52. Mind, matter and motion …………………………………….………………………………..………… 317
53. Motion …………………………………………...……………………………………………………..… 322
54. The therapeutic potency ………………………………………………………………….…………….. 325
55. The whole patient needs a whole physician ………………………………………………….…….… 330
56. What is man that thou art mindful of him: Part I ……………………………………………………… 333
57. What is man that thou art mindful of him: Part I ……………………………………………………… 336
IX International Osteopathy
58. Osteopathy in the cranial field - makes its debut on a new stage - the University of the Sorbonne 343
59. By invitation only ………………………….……….……………………………………………………… 346
X Alexander Tobin 1921 – 1992 ……………………………………………………………………… 359
Ruth Kelley 1902 – 1987 ..…………………………………………………….….………………… 360
Editor's Foreword
This book, commissioned by the AAO, presents a portion of the work done by Viola M. Frymann, DO, FAAO, FCA in her service to humanity. Through her direct contact with patients, parents. students and colleagues Dr. Frymann has guided, encouraged, inspired, and challenged with deep and telling effect which may be only sensed in these papers. These papers are some of the products of a truly remarkable career in osteopathic medicine, spanning over fifty years, and still going. In these papers we see the manifestations of her life as a scientist, teacher, physician-healer, philosopher, mother. and steward of the profession. Herein presented is a broad. but pure, perspective on osteopathy.
Dr. Frymann produced significant clinical research, presented in the first section of papers. This research is cited in virtually every book on osteopathy in the cranial field published since the 1960s. As Dr. Frymann's contributions are put into historical perspective these research papers may be among her most significant. This is due to their impact on an audience of osteopathic clinicians who needed proof of the cranial concept. By the end of the 20th century the cranial concept has had most of the elements scientifically demonstrated, directly and through encouragement to others by Dr. Frymann.
Those of us privileged to have worked and taught with Dr. Frymann recognize that the papers on Applications of Osteopathic Principles in Clinical Practice and Osteopathy in the Cranial Field are not a complete set of all her teachings. Many of these papers have never before been published. We would have desired more such papers from Dr. Frymann on some of her favorite topics like "respiration" and the "anatomy of the cranium." This volume contains all that has been written to the present time. This material is an excellent adjunct to any course on osteopathic manipulative medicine.
The great passion of Dr. Frymann's life has been her work with children. This passion was in part prompted by the loss of her first child and the subsequent realization that osteopathic manipulative medicine, particularly osteopathy in the cranial field, might have prevented this loss. Work with all children, but especially children with special needs like "cerebral palsy" and "learning difficulties," has been the signature characteristic of her work at the Osteopathic Center for Children. The papers in The Osteopathic Promise To Children and For Families and Parents were written for the lay public, but contain much for the professional in how to present this material effectively. It is expected that this book will serve to introduce parents and families to the work of the Osteopathic Center for Children and Dr. Frymann.
Over the course of her career Dr. Frymann has received many awards and honors for her service to the profession and her patients. She is a fellow of both the American Academy of Osteopathy and the Cranial Academy, and has served terms as president of both organizations. The Invited Lectures were likewise honors vested by these organizations and served as opportunities to address issues of importance to the osteopathic profession. Her development of A.T. Still's "Law of mind, matter and motion" and "Motion - the difference between life and death" are indeed worthy present-day amplifications of the thoughts of the profession's founder. The section on Osteopathic Medical Philosophy continues themes expressed in the Invited Lectures. Some of the papers address similar issues, but develop the points in a sufficiently different manner to stand on their own. Dr. Frymann applied osteopathic medical philosophy in the context of the totality of the healing, medical practice and medical research endeavor. She lived what she espoused. In the parlance of the 1990s, she "walked the talk."
In like manner, Dr. Frymann combined her religious and spiritual principles with osteopathic philosophy to give consideration to applications of what is called "alternative," "complementary," or "integrative medicine." Every Saturday morning when she was in town Dr. Frymann had a Bible study and prayer group that met at the Osteopathic Center For Children. As a recipient of this prayer I can say from personal experience it was a most powerful force. This prayerful and spiritual expression was directed primarily to her patients, especially the children. As one who treated many of her adult patients after Dr. Frymann started treating only children, I heard stories of truly miraculous treatment outcomes apparently as a result of the manipulation augmented by prayer and application of healing principles based on energy medicines such as homeopathy. In this context must be mentioned Mary Helen Powers who assists Dr. Frymann in the treatment of the children and her contribution to the positive healing atmosphere of the Osteopathic Center for Children during the past 35 years.
Dr. Frymann's international work began in 1964. She has taught and helped develop individual practitioners and program throughout the world. The section on International Osteopathy chronicles some of her experiences and highlights of her travels. Dr. Frymann's work has had great influence on the development of the practice of osteopathy world wide, an accomplishment which has resulted in an international reputation possibly even greater than in the USA.
The tributes to Alexander Tobin and Ruth Kelley close this collection and in part describe an episode in osteopathic history which threatened the existence of the osteopathic profession. Dr. Frymann was one of the leaders in reestablishing the infrastructure of osteopathic medical practice in California in the 1960s and 70s. It is hoped that this collection will constitute not only a tribute to Dr. Frymann's illustrious career but also inculcate knowledge which will strengthen the practice of osteopathic medicine ensuring fulfillment of the dreams of the profession's founder.
- Hollis Heaton King, DO, PhD
PREFACE
Viola M. Frymann, DO, FAAO, FCA
I came to California to study osteopathy, upon which my family had totally depended since I was 4 years of age. Through the care of a dynamic exponent of these methods, a sick father and a puny child found health. Thus, I knew the potential of this practice.
But the profession in California, unbeknownst to me, was already on a secret destructive road to annihilation. I soon realized that if I were to find what I came for, I must search for myself. My first study resulted in an essay for the Academy of Applied Osteopathy 1948 contest on the role of the osteopathic lesion in cardiac pathology. The following year I was challenged to explore the role of the osteopathic lesion in functional and organic renal pathology. The library at tje College of Osteopathic Physicians and Surgeons had become my resource.
It was the repeated reference of a patient to the work of Thomas Schooley, DO, who had successfully treated her headaches, that sent me with great trepidation to attend a course in Denver on the very controversial subject of osteopathy in the cranial field. William Garner Sutherland gave the first lecture, and it was on the vomiting of the newborn. He described the trauma of birth and the resulting distortion of the occiput that would compromise the vagus nerve. A quick and simple technique would, he declared, promptly solve the problem. I had recently lost a baby witl1 uncontrollable vomiting despite everything that had been recommended. I could scarcely believe what I had just heard. It was too logical, too simple. But my baby had had a hard labor and was born with a distorted head. I had to find out whether tl1is theory was true. With but a few weeks of experience with tl1is cranial osteopathy, I persuaded the local osteopathic hospital to let me examine newborn babies. With the naivete of a neophyte, I was confronted with a devastating inadequacy of palpatory skills. A workshop in palpation was then developed with the assistance of the writing of the renowned professor of the piano, Tobias Matthay, and the discovery that the skill of manipulating piano keys to produce real music had much in common with the technique of osteopathic palpatory diagnosis and treatment. Only after the palpatory education was I ready to formulate conclusions concerning newborn babies.
This was the era of skepticism. Unless you can demonstrate in the research laboratory and record on a graph that cranial bones move, the PhDs of the osteopathic profession vehemently declared, there is no validity to this concept. Another patient came to my assistance. F. George Steele, who was a pioneer in the early development of the computer, workdays accepted this challenge, and for several on years we labored together evening after evening when our workdays were concluded, when suddenly on May30, 1968, the cranial rhythmic impulse was recorded on the oscillograph. There was great rejoicing and a new avenue of essential osteopathic research was about to open.
The wonderful early student of Sutherland, Rollin Becker, DO, used to tell me, "by our patients we are taught." It was another patient who introduced me to a pioneer in the field of learning difficulties of children, Amorita Treganza, OD. In fact, she and I grew together in this field and published a joint paper in 1973. Harold Magoun Sr. DO, FAAO, another early student of Sutherland and a prodigious worker in furthering osteopathy in the cranial field, challenged me with the question, “What is different in the crania of children with learning disabilities?” I had no idea of the answer, but I did have hundreds of records from which I could discover the etiology of learning problems.
A telephone call in 1976, from Eugene Dyer, DDS, a professor of dentistry at the USC School of Dentistry, demanded an 8-hour seminar for the dentists on temporomandibular joint (TMJ) dysfunction! I tried to convince him that all I knew about the TMJ could be said in 15 minutes, but he would not take "No" for an answer. Once again the needed patient arrived. As I sat with a mother giving me the history of her daughter I was fascinated by the devious motions of her jaw as she talked. "Do you have a problem?" I asked. Her response described her intolerable pain and dysfunction in both TMJ's following the forceful clenching of her teeth during a very difficult labor. She now became my patient and hence my teacher in preparation for this dental seminar. This seminar opened the door to the dental profession. Dentists began to realize they were influencing more than teeth: the teeth were outgrowths of bones that articulated directly or indirectly with all the bones of the head which in turn were related to the whole patient. Furthermore, Osteopathy in the Cranial Field could profoundly improve malocclusions; orthodontists discovered that their work could be profoundly enhanced if they had the opportunity to consult and work with the osteopathic physician.
In 1978 California opened the College of Osteopathic Medicine of the Pacific. It was not my intention to join any college faculty, but by January of 1979, Philip Pumerantz, PhD, the President challenged me to provide the introduction in osteopathic principles and practice that I had promoted over so many years. Seven years followed of commuting 500 miles per week and maintaining a private practice while developing a department osteopathic principles and practice at the college. A curriculum was developed, handouts to enhance it were created, and certain issues relative to practice were addressed. One of our first students to be selected an undergraduate teaching fellow in osteopathic principles and practice was receiving his education on scholarship from the US Air Force. He was refused the I-year deferment in order to fulfill his fellowship. I sought advice from osteopathic physicians both within and retired from the Air Force in order to prepare compelling document explaining why this extra education in osteopathic principles and practice would provide a flight surgeon with added skills of great value to the health of air force personnel in general and fliers in particular. This document ascended the ladder of the medical officers of the Air Force to the desk of the Surgeon General, but it was to no avail ... except that I learned important clinical material in the process.
Prevention is an important aspect of osteopathic practice. An article was formulated to stimulate the thinking reasoning process and to raise critical questions to influence a philosophy of practice.
For the 21st anniversary of the California state association, Osteopathic Physicians and Surgeons of California requested an article on the profession for their commemorative issue. A vision for the future was written. I described a center for the osteopathic care of children where the problems resulting from the trauma of birth would be recognized and corrected, where prevention would be paramount and would enable children to grow into healthy, happy, productive citizens. A grandfather read this newly published article while I treated his grandson. “I want to give you a check,” he said. When I inquired what for, he pointed to the article and said, “for this, what is it called?” It was only a vision, but in conclusion it stated, “This is osteopathy’s promise to children.” Unwittingly, the vision was validated and Osteopathy’s Promise to Children was established.
Our students m COMP (College of Osteopathic Medicine of the Pacific) needed clinical rotations. Our practice in La Jolla had focused on the problems of children since 1962. With the generous help of the Irene Anderson Foundation, a comprehensive remodeling operation was performed, and the Osteopathic Center for Children, a teaching affiliate of the College of Osteopathic Medicine in Pomona, was founded in 1982.
Another research project was now of possible, namely the outcome of the osteopathic management of children with neurologic developmental problems. In cooperation n with Peter Springall, PhD, a neurologic developmentalist, a developmental profile was developed and used to evaluate a child's developmental status before, during and after the osteopathic treatment program. Significant progress in response to such care was now demonstrated and documented in the literature.
In conclusion, reading the articles in this book that were written when I was seeking answers may now be recognized as the learning experiences I needed, and will I trust, meet the unfolding osteopathic needs of the readers.