Yes I know this sounds like a Deepak Chopra meditation concept but have you ever considered that your body is built with the ability to repair and heal? Well, this is the third of A. T. Still‘s main Osteopathic principles that I am going to address and hopefully as a result you, and who ever you share this information with, will gain the much deserved respect for the awesome machinery you were born with.
So far we have looked at homeostatic mechanisms, the holistic perspective of Osteopaths and the relations of structure and function. This Principle is linked to both of the previous ones for reasons you will surely understand by the time I’m done throwing examples at you!
OK lets start with a basic injury, a graze. This is an epidermal wound and although they can reach the dermis layer in the center, the edges are usually epidermal. Basal cells (of the wound’s epidermal edge) break away and migrate across the wound. These cells move until they meet cells from the other edges, when they are then stopped by a cellular response called ‘contact inhibition‘.
While these cells are moving across the graze, the epidermal growth hormone causes the edges’ basal cells to proliferate, replacing those that are moving. Once the wound has been covered with this first layer of basal epidermal cells they then begin to divide forming new strata and thickening to form a new epidermis (1).
Quite a feat when you really think about it but you don’t actually have to, as this is a perfectly natural response to that type of injury.
Deeper wounds are a bit more complicated due to the layers of tissue affected. Healing deep wounds consists of four phases:
- Inflammatory phase.
- Migratory phase.
- Proliferation phase.
- Maturation phase.
Aulus Aurelius Cornelius Celus gave four distinct characteristics to inflammation: redness (rubor), heat (calor), swelling (tumor) and pain (dolor). Loss of function (functio laesa) was later added by Berlin Pathologist Rudolf Ludwig Karl Virchow (2). The inflammation phase involves cellular, fluid and tissues in a complex interaction. A blood clot forms uniting the edges and preventing an excessive loss of blood. Vasodilation of the peripheral blood supplies leucocytes during the active phase of inflammation (3). Other helpful cells such as neutrophils; which develop in to macrophages able to phagocytize microbes, and mesenchymal cells; which become fibroblasts (4) are also supplied at this time.
The migratory phase consists of epithelial cells migrating beneath the now scabbed clot, bridging the wound. The fibroblasts synthesize scar tissues and blood vessels reform.
After this epithelial cells proliferate extensively beneath the formed scab. You can guess what phase this is!
Once the epidermis returns to its original thickness the scab falls away. The blood vessels are restored to normal and fibroblasts decrease in number. This is the maturation phase.
Now these are just flesh wounds! Imagine how much your body has to go though to repair fractures!
To stop your eyes going blurry here’s a nice little video to show you:
Tissue trauma isn’t the only self healing that your body deals with. We are exposed to numerous pathogens daily, these include bacteria virus and fungi. Numerous bacteria already reside in our bodies, for example E. coli.
Innate immunity defences range from external physical barriers as well as biochemical defenses both externally and internally. The internal defence involves the previously mentioned phagocytic cells as well as cells which mediate inflammation. Adaptive immune responses are more specialised in dealing with pathogens. The proliferation of B and T cells occurs when the surface receptors of these bind to specific antigens. These then release the required antibodies responsible for destroying the extra cellular microorganisms (5).
All of these reactions occur without us being aware of them. Its a natural response for our body to repair damage and protect itself. This helps with the maintenance of homeostasis and keeps us functioning as optimally as possible in the circumstances we expose ourselves too.
The cells involved in immunity are provided by certain organs in the body.
Bone marrow provides leucocytes (neutrophils and monocytes) as well as lymphocytes (basophils and eosinophils), though the latter are also produced in the lymphatic system (6). So this shows a dependency on these systems to provide the required cells for protecting our bodies, relating back to the two previous principles I’ve discussed.
Most of the links provided here are to Wikipedia. I can’t stress enough that Wikipedia can be altered by anybody so the information given may not be 100% accurate, but I do also provide references and links to the books I use in these blogs.
So far the three principles covered should begin to make sense. Their relationships and relativity are reasonably clear (hope so!) and the final principle will also interlink with these nicely. Each one of these principles is directly related and effective upon the others. Broad statement I know, but this is exactly what I am being taught to understand rather than learning things in a reductionist manner and in all honesty I prefer this to the more traditional segregation used in medical sciences.