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56 m a s s a g e & b o d y w o r k s e p t e m b e r / o c t o b e r 2 0 1 6 Instead, we must now see it as a constitutive fibrillar framework in which the organs are but local, functional adaptations. Groups of cells with specific, specialized physiological functions are assembled within a multifibrillar network to form the organs. The cells are embedded in and supported by the fibrillar framework. This basic architectural pattern is the same for all the organs, as well as for the skin, fat, muscles, bones, tendons, nerves, and vessels. Through my work studying the living body, I suggest a new model that describes the human body's structural framework and the basic architecture of living matter—in other words, a new structural ontology. A JOURNEY TOWARD DISCOVERY Surgeons observe the same gross anatomy in all human beings. Our bodies are constructed from the same blueprint, so we all have two arms and two legs, and our internal organs are disposed in the same manner. However, when you begin to observe anatomical structures close up and in detail, you find that we are all different. The individual makeup of each human being is unique. These observations of a questioning surgeon did not prepare me for what I found. I was simply trying to understand how tendons slide through neighboring tissues so that I could develop a technical Compare this perimuscular fibrillary mesh photographed by the author during surgical endoscopy of a living patient ( Image 1, no magnification), with that of similar perimuscular fibrillary mesh (dead and dissected) as seen through an electron microscope ( Image 2, black and white, 10x). RETHINKING WHAT WE KNOW Progress in digital endoscopic videophotography now allows us to see the living components of the human form. Observations made in vivo (Image 1) show structural elements that are difficult to identify from cadaveric dissection or from the study of preserved tissue samples (Image 2). Even the most sophisticated histological techniques fail to reveal these structures, but using digital videoendoscopy to observe living tissue, we see that a profusion of fibers, fibrils, and microfibrils are revealed at both the mesoscopic and microscopic levels This continuous network of fibers appears to extend throughout the body, suggesting we need to rethink our understanding of the way in which living matter is organized. We can no longer view the body as a collection of cell-based organs held together by connective tissue. Fascia, the fibrillar network, is one of total tissue continuity. Understanding this crucial insight enables us to visualize our body as a "global" structure with a specific, three-dimensional architecture made up of elements that, while fragile, have a stubborn capacity for adaptation. This suggests there is an architectural system for all living organisms, the role of which is far more important than simply connecting things. It is actually constitutive. After 20 years of intratissular endoscopic research carried out during more than 1,000 surgical procedures, I wanted to share my astonishment at the revelation that cells do not occupy the entire volume of the body, and are not responsible for form. In fact, the extracellular world, ignored during more than half a century of research, is as important as the cellular world. 1 2