cranial osteopathy

William G. Sutherland’s cranial osteopathic concepts are arguably the most cherished and guarded ideas within osteopathy. No other topic engenders the degree of debate, controversy, defence or criticism that a discussion of Osteopathy in the Cranial Field (OCF) will invariably spark. In fact, a recent study published by myself and three French colleagues resulted in the most letters to the editor for a single article in more than 10 years.

In the latest issue of the International Journal of Osteopathic Medicine, there is a fascinating article discussing the likely origin of most of Sutherland’s cranial osteopathy concepts. According to the author, Theodore Jordan, in 1744 a well-known 17th-century physician-turned-mystic, Emanuel Swedenborg, published a text titled The Brain, which described ideas similar to the first four of the five components of Sutherland’s cranial concept.1 It is known that Sutherland had a copy of an 1882 translation of this text, and on a few occasions he had made reference to Swedenborg’s ideas, even comparing Andrew Taylor Still’s anatomical study of “the handiwork of his Maker-the body” to Swedenborg’s search for the “seat of the soul” within the human brain. It appears that Sutherland integrated a significant portion of Swedenborg’s anatomically-based paradigm of rhythmic brain-body interaction into osteopathy as he developed cranial osteopathy.

This knowledge will be a revelation to many osteopaths, as it was to the editors of IJOM. However, it appears that it is not unique. A quick search on Google revealed a free access copy of the annual address delivered at the Annual Meeting of the Swedenborg Scientific Association on April 26, 2008 by David B. Fuller. This 32-page paper details a comprehensive overview of Swedenborg’s paradigm of the brain and nervous system and a comparison to Sutherland’s cranial concept.

For many osteopaths, the extent of anecdotal evidence supporting both the descriptive model and clinical outcomes is interpreted as sufficiently compelling to justify continued use of OCF treatments in clinical practice. Unfortunately, substantiating evidence of the commonly accepted explanatory models of OCF is yet to be established. In this regard, Jordan’s closing comment is worth careful consideration:

“Critical dialogue regarding cranial osteopathy is a crucial component that can only strengthen the osteopathic profession. The PRM model has been part of osteopathic thought for over 60 years. To understand that it is based on an abandoned eighteenth-century physiological hypothesis will hopefully propel the osteopathic profession to open a dialogue that will serve to advance our science.”



1. Jordan T. Swedenborg’s influence on Sutherland’s ‘Primary Respiratory Mechanism’ model in cranial osteopathy. International Journal of Osteopathic Medicine. 2009;12(3):100-105.

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