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C h e c k o u t A B M P 's P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 45 The explosion in fascia research over the past couple of decades has been nothing short of spectacular, as is the breadth of research reaching practitioners through seminars (now webinars), the phenomenal Fascia Research Congresses, and translations of clinically applicable methods. It is hard to believe that in the space of a few short decades, research— and practice—regarding the tissue once destined for "the cutting-room floor" 1 has multiplied exponentially whereby the understanding of therapeutic approaches to dysfunction and homeostasis is undergoing a radical paradigm shift that looks set to continue. Practitioners—and students of osteopathic medicine in particular—may feel gratified by what appears to be a confirmation of sorts, of the prescience of the profession's founder, Andrew Taylor Still, in stating that "the fascia is the place to look for the cause of disease, and the place to begin the action of remedies." Still and his early successors may not have fully understood the mechanisms and pathophysiological processes via which this occurred, since his approach was rooted in a rather different—some would say outdated—model of health and disease without the benefit of modern research methods and technology. Nevertheless, Still had a point that modern research is now beginning to bear out. Namely, that the entire body is interconnected by a physical matrix, the distortion of which can lead to disease and dysfunction. 2 It is for the experts in this field to provide the fine detail of what the study of fascia entails, as they are already doing. My interest, and the focus of this article, lies in using the evolution of our understanding of fascia as a case study to look at the evolution of how we think and learn—as a society and as therapeutic professions—about health and disease, and what insights the story of the evolution of this field can offer. WHY FASCIA? Since the evolution of all medical fields has followed a similar trajectory (up to a certain point in time), some may wonder, why choose fascia? Fascia specifically presents a unique case, because unlike studying in cardiopulmonary, vascular, or orthopedic fields, it has the rather inconvenient—until recently—quality of interconnecting all of the bodily systems, while its stimulation or dysfunction can also have a psychological effect, autonomic or otherwise. Not only that, but the understanding of fascia carries with it a set of roots firmly embedded in vitalism, as did the whole medical profession until about 300 years ago. But these roots were firmly severed with the advent of the modern scientific method. Biomedicine, based on mechanistic and physicochemical explanations of physiology, took primacy over all other interpretations, and vitalism became a dirty word in early modern scientific circles. The same has not occurred in many of the branches of the integrative health professions, where particularly osteopathy, chiropractic, massage therapy, and other subdivisions retain elements of vitalistic thought—some overtly and others less so. Yet, it remains a subject of often heated debate even within naturopathic circles. Vitalism is an ancient perspective on the living organism whereby life itself and organic processes result from a nonphysical vital force within that organism. Some call it "energy," others simply "the life force." In traditional chiropractic, vitalism was once known as "innate" and "universal intelligence," while in naturopathic medicine it has been referred to as "the healing power of nature" (vis medicatrix naturae), a perspective that goes back to ancient Greece. 3 It is at once a philosophy, a worldview, and an ideology—and they are not the same. Intelligent Fascia? By Sasha Chaitow, PhD education SOMATIC RESEARCH

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