The Posture Theory Home Page

 

The Nature and Complexity of Empirical Theory

(in relation the The Posture Theory and The Antiseptic Theory of Semmelweis)

16-5-06
Semmelweis's Insanity

 

Introduction

The Posture Theory is based on observation and thought, with trial and error and experimental experience used to assess the correctness or otherwise of an idea, in order to determine cause and effect from direct and obvious results, and trends and patterns not clearly apparent to casual assessment.

This sort of theory generally has less acceptance than scientific theories which are essentially based on what can be seen with the eyes, microscopes, x-rays, and statistics etc, where variations from consistency are ruled out as contradictions.

However in general terms an empirical theory always comes first and the scientific determination of it after, sometimes centuries later.

In the meantime serious problems are likely to be encountered by the inventor of the idea which are not generally appreciated, so I would like to relate the experience of an empirical theorist called Ignaz Philipp Semmelweis.

The Empirical Theory of Semmelweis

The Hungarian physician Ignaz Philipp Semmelweis (1818-1865), was born in 1818 and became educated in medicine and then an assistant obstetrics surgeon working in the Vienna General Hospital.

He began an intensive study of child bed fever, or perpeural sepsis, now known as septicemia or blood poisoning, and now recognised as being caused by a bacterium which enters the birth canal during childbirth.

However prior to Semmelweis the actual cause was unknown and it was attributed to milk fever, miasma, or cosmic telluric, but in 1843 an American Doctor name Oliver Wendell Holmes developed a theory that midwives were infecting mothers with their dirty hands and instruments. Semmelweis considered this possibility despite the forceful opposition of the head of his department. Unfortunately he was unable to identify a contagious agent, but then a friend of his, Dr. Jacob Kolletschka, died of septicemia after cutting his finger while performing an autopsy on an infected woman, and he realised that he had died of the same disease.

He also observed that the death rate in the wards where students were taught was 400% greater than in the wards where midwives were trained, and he realised that the students had been performing autopsy studies as well, whereas the trainee midwives were not. He therefore theorised that putrid or cadaveric material was being carried on the hands of students from the autopsy room to the patients in the obstetrics room.

He then acted on the basis of this theory that the disease could be prevented by instructing all students and physicians who entered the obstetrics ward to wash their hands in a solution of chloride and lime, and following some initial success he then extended the practice to cleaning all surgical instruments and utensils.

His methods were spectacularly successful in reducing the death rate but he responded in an argumentative and belligerent manner to the resistance of his superiors who refused to accept his ideas and practices, and as a result they blocked his path to being promoted to a position of authority as clinical professor.

He angrily left the Vienna hospital and later gained employment at the University of Pest, where he taught his antiseptic techniques to thousands of students 15 years before the more famous demonstrations of Lord Lister of England.

Semmelweis also later wrote books and letters about his successful treatment of Child Bed Fever, and lashed out at those who rejected his teaching .

Unfortunately, in 1857 two of his own children died in infancy, and with that coming on top of many years of arguments an opposition, he succumbed to a serious mental illness.

He died in 1865 from an infected finger which he cut while doing an autopsy demonstration for his last class of students.

He was "one of the great tragic figures of medical history, . . . and the classic example of the dedicated scientist whose very dedication antagonised entrenched conservatism and eventually destroyed him."

Reference: Collier's Encyclopedia 1962 Vol.20 p.587-588


Semmelweis was committed to an insane asylum where he died
There were other reports that the resistance to Semmelweis ideas was because there were doctors who were not eager to admitting that their failute to clean their insturments was the cause of so many deaths in their own patients.
The reports also suggest that his ideas produced heated arguments which resulted in his ideas being rejected, and him going mad and being sent to an insane asylum where he died. See here and here

Since Semmelweis

I can recall reading of late 19th century doctors who would call on farmers who had injured or broken their legs and developed gangrene. The surgeon would arrive at the farm and collect a rusty saw from the barn, wipe off the wet cow dung with their hands, and then amputate the patients leg on a kitchen table. 95% of such patients died of infection, and the doctors argued that they would have died anyway because the body was already diseased.

I can also recall reading the biographies of Robert Louis Stevenson. His wife Fanny Stevenson had read the latest medical literature and was familiar with ideas about contagious infections and "germs", but some of the doctors who came to visit Louis would sneeze all over him and refuse to believe that they were causing problems. Fanny had to argue with them and insist that they didn't sneeze on him, and when she insisted that her friends not enter the house while they had colds, or that they should cover their mouths with handkerchiefs, they branded her as an irrational hypochondriac. I am sure that doctors were largely responsible for spreading many of the great plagues of Europe by sneezing over patients, and using dirty hands, and carryinng dirty instruments from one plague ridden patient to another.

I can also recall the example of Florence Nightingale who was sent to the military hospitals of the Crimea where the death rate was 44%. The patients would come in with knife or bayonet wounds and get sick with vomiting, diarrhea, bleeding, and pus being left on their bed sheets after they died, and so the next soldier with a simple cut would be thrown into the bed to get infected and die. Toilet buckets were next to each bed and emptied into the toilet barrel each day and the barrel would be emptied each week. Bed lice and other bugs, infected mice, and rats, and dirty floors, and dirty clothing etc would have contributed to the high death rate.

Florence Nightingale met with considerable resistance from the surgeons in charge of the hospitals but she had authority to override them, and by cleaning the bed sheets, clothing, and ward floors, and by taking toilet buckets outside, the death rate dropped from 44% to 4%.

Scientific Theory

Since the time of Semmelweis, Fanny Stevenson, and Florence Nightingale the world has seen the development of microscopes, X-rays, and antiseptic techniques backed by statistics, and now every scientist can see the "germs", and the effect of antiseptics, and the public believes everything that scientists tell them.

When modern surgeons operate they wear caps, gloves, gowns, socks, and masks to prevent the transmission of "germs", and hospitals have procedures and staff for cleaning floors, bedding, and instruments, and some wards with immune deficient patients have filtered air, and the food is hygienically prepared and transported.

Tens of millions of people owe their life to Semmelweis, but most people have never heard his name, or know that the medical establishment ignored and belligerently resisted his ideas, blocked his promotion to positions of authority, and drove him mad.

The Posture Theory

The Posture Theory is an empirical theory based on detailed observation, conclusion, trial and error, implementation and success, but most of it cannot be scientifically proven. According to modern medical science 15% of postural deformity is due to such things as arthritis and tuberculosis of the spine, and other factors which are evident on X-rays. The cause of the remaining 85% is unknown. The logical, deductible, and obvious experiential causes of spinal deformity and postural back pain clearly described in The Posture Theory, but are not evident on X-rays, and neither are most of the other postural induced pains and illnesses!!!

 "Approximately 80% of cases of kyphoscoliosis (stooped spine) are of unknown cause". Most of the remaining 20% follow poliomyelitis or Pott's disease.
Reference: Harrison's Principles of Internal Medicine 6th edition (1970) p.1299

"Scoliosis: About 85% of all cases of curvature of the spine fall into a classification known as "idiodathic" (unknown cause) scoliosis. In this one large group of cases the etiology (cause) remains obscure". Of the remainder 10% follow poliomyelities, 2% are due to Von Recklinghausen's Disease or neurofibromatosis, and less than 2% are due to congenital bone disorders in the spine, osteochondrodystrophy, Friedreic's ataxia, cerebral palsy, and some muscular dystrophies. Also, less than 2% follow empyema, thoracoplasty, or any other factors which change the chest shape during the growth period". . . . "There is still considerable controversy in the whole field of scoliosis ... wherever possible it will be to the patients advantage to be followed by someone with special interest and experience in this disease".
Reference: The Specialties in General Practice (1951) p. 72-74

Perhaps it will be several hundred years before The Posture Theory causes of spinal deformity and backpain becomes scientific.

 

In the meantime I must say that I can identify with the problems and antagonisms of Semmelweis, but I have had the advantage of some early training in social studies, and I have good social and communication skills, as well as a good personal understanding of a wide range of people and experiences which enables me to deal with those problems, sometimes with difficulty, but more often routinely. I have also had the support and encouragement of a small number of doctors and professors, and Sir Mark Oliphant, so I have not been existing in some sort of singular social vacuum and haven't ended up thinking that I am odd or alien. I have never believed that I was wasting my time because most of my good ideas have benefited me, if no-one else, and I have learnt from the mistakes of people like Semmelweis, and have not let ignorance, scepticism, and or rejection of the ideas bother me, at least not to the extent of insanity. It is just a predictable fact of life that anyone who produces a theory which replaces an established idea is going to be met with powerful, unreasonable, and unjustifiable resistance.

Semmelweis Insanity: A form of mental disturbance which is caused by the disappointment of conflicting circumstances, where a person proceeds with the best of intentions to accomplish something of value with the expectation of reward, but is treated as if their motives were heinous and they were derided, rejected and punished. M.B.


The Posture Theory is an empirical theory based on tens of thousands of observations and ideas which were put together haphazardly over a thirty year period as the complicated interrelation of clues presented themselves for assessment , and to describel them in the interwoven way that they occurred would create more confusion than is practical to contemplate so, with the benefit of hindsight I tried to put tthem in chronological order, so that other people to make sense of them.

The following text is taken from pages 49-53 of the 1000 page 11th edition of
The Posture Theory which was published in October 2000.

The June 1980 edition of The Australasian Nurses Journal included an article entitled "The Matter of Framework" which I have subsequently called "The Posture Theory". In that essay I described how poor posture could cause a downward pressure on all the internal organs and produce the broad range of health problems involved in hypochondria. The symtoms included fatigue, abdominal pain, breathlessness, palpitations, faintness, kidney and bladder problems, constipation, and many more.

The Posture Theory diagram was first used on my booklet "A Decade of Theories 1976 - 1985" published in 1986. Concentric internal lines have been added to show how the shape of the external body can affect the contours of internal anatomy temporarily or permanently.

The Origin Of The Posture Theory (Originally from the 10th edition)
The Posture Theory (1975-1980)

I became interested in medicine in 1974 when I found that there were many common ailments for which the cause was unknown because there was no evidence of broken bones, open wounds, or infections. I also found that some individuals had multiple and varying symptoms which included abdominal pains, chest pains, breathing problems, neckache, back pain, fatigue, and many more. I was curious to know how such problems could evade detection and I wondered if there were separate causes, or perhaps a single common cause, and I began a search, which unknown to me at that time, was to take me five years to complete.
I started by assessing those conditions one at a time.
For example, I considered the idea that undetectable abdominal pain might be due to a wound which was hidden between several layers of muscle in the stomach region.
I also thought that it may have been due to different types of food which may have been acidic, or spicy, or irritant to the stomach. I also considered that there may be some delay between the time food was eaten and the time it reached a tender section of the abdomen, and that the delay would create confusion about the cause. Eventually I considered that leaning forward might compress the stomach to cause stomach pain, and that led me to consider that bending might compress the chest to cause chest pain.
I then considered how bending forward might affect breathing. In that regard the chest and abdomen are separated by a sheet of muscle called the diaphragm, and when it descends it creates a vacuum in the chest which draws air into the lungs, and when it rises it pushes air out of the lungs. I thought that leaning forward might stop the diaphragm from rising to it's maximum height, and that wearing a tight belt might interfere with it descending fully, so that much less air entered and left the lungs with each breath. Therefore breathing would be shallower and more rapid, less oxygen would be consumed, the diaphragm may be strained or damaged, and the lungs would become congested, and the breathing reflexes might become adversely affected.
One year, while I was considering a possible postural cause of kidney problems, I drew a diagram of the side view of the human body in a seated and slouched position to see how slumping forward might affect the kidney. I noticed that I had drawn the body with the head erect with the eyes directed forwards, and that as a consequence I had drawn a forward arch in the neck.

I then concluded that the middle bone in the neck would be pressing forward against the spinal nerve and the throat, and that the strain could cause neckache, and sore throat, and tension in the muscles of the neck and lower head which could result in headache. I then noticed that the jaw joint would be out of alignment, possibly causing jaw and dental problems, and that the tubes which drain the sinuses could be obstructed at their junction with the throat, thereby causing congestion of the sinuses.
In 1979 I was considering the cause of chronic fatigue which, in the nineteenth century was called neurasthenia (neuro = nerve, asthenia = weakness), and I was examining a procedure called Valsalva's Manoeuvre which was described as an experimental method for stimulating the nervous system. That procedure involves holding the mouth and nose shut and breathing out forcefully to increase the air pressure inside the chest. The effect is to slow the blood flow from the feet to the heart so that the nervous system responds by stimulating all of the bodies arteries to contract. That increases the systemic blood pressure which forces blood through the chest. I then realised that poor posture could repeatedly compress the air in the chest and overstimulate the nervous system and cause problems with blood pressure and chronic fatigue.
I was then able to write an essay which linked a framework of ideas to a framework of symptoms which were related to the framework of the human body so I called it "The Matter Of Framework". That essay was published in June 1980 and was the original Posture Theory.
During the next 14 years there were no significant additions to the idea.
The Posture Theory (1994-1999)
In 1994 I found an old medical book which contained an illustration of the internal anatomy of a woman who had worn a tight waisted whalebone corset. The stomach, which is normally in a horizontal position in the upper abdomen, had been pushed into a vertical position, and all of the other abdominal organs were deformed and displaced.
I then found a nineteenth century book which had a list of almost a hundred symptoms and ailments which eminent doctors of that time attributed to corsets, so I had found evidence and logical proof of The Posture Theory. i.e. that if poor posture compresses the abdomen, it can therefore produce a multitude of health problems.

I then published a small booklet called The Posture Theory and began compiling evidence in subsequent editions about every 6 months.
Since then there have been a number of significant improvements to the idea.
For example, I found that children with poor eyesight are likely to develop a bent spine as a result of repeatedly leaning forward at a desk to read. Moreover, as a secondary effect they develop rounded shoulders and their chest tends to grow flat, or in some cases, to actually incline backwards to create a funnel shaped chest. The next consequence is that eventually, each time they lean forward, they will be virtually stabbing themselves in the stomach with the blunt cartilaginous tip of their own dagger shaped breastbone.
I then noticed that as a right handed person writes their right hand moves to the left margin of the page and proceedes across to the right margin, and then quickly back across and down to the left margin of the next line. In the process of completing a page of text they repeatedly twist and untwist their spine, and their stomach, and their sword shaped breastbone, and they press and twist the tip of their breastbone deeper into their abdomen as they proceed down the page.
I also determined that such problems could be prevented by sitting with good posture, or by bending at the hips instead of the waist, when leaning toward a desk.
I then concluded that posture could be improved by standing up and writing with the page placed on an elevated bench, and preferably with the page on an inclined surface.
I then noted that by preparing a text on a computer the left hand remains on the left side of the computer keyboard, and the right hand remains on the right side, so the spine does not get repeatedly twisted in the process.
Ultimately the tendency to lean forward can be minimized by placing the keyboard at waist height, and the computer screen at eye height.
Those are the main conclusions of The Posture Theory to this current time.
In the process of adding the additional ideas to the 1994 booklet The Posture Theory became quite a large book but as it grew in size and scope the mixture of ideas, evidenc and illustrations became complicated and confusing so I separated the information into individual units which did not have the form of conventional chapters, so I called them sections. My objective was to maintain a logical sequence of easily understood ideas so the book now starts with an introduction, followed by some ideas on the cause of hunchback, then by some quotes and references from various books, and then by some diagrams of slouching. Those pages are followed by some ideas and references for the cause of sideways curvature of the spine, and then by information on other deformities. I then present information on the affects of poor posture by providing ideas, quotes and diagrams about the cause of individual symptoms.
Section 2 considers how the enlarging womb of pregnancy can compress internal organs and alter a womans posture to cause similar problems, and there are quotes and diagrams to support that idea. Section 3 considers how tight corsets and tight clothes affect health, section 4 deals with visceroptosis (the obsolete medical term for displacement of the abdominal organs), section 5 gives some miscellaneous examples of other factors which can compress or displace internal anatomy, section 6 provides some treatment suggestions, and section 7 presents a brief conclusion.
Some of the individual subjects had so much information supporting them that the sheer bulk was confusing the running flow of the text so I established an entire new volume at the back of the book and set up new sections on abdominal pain, blood pressure, and menstrual pain etc..
I then introduced biographical information to support some of the ideas by suggesting how posture or clothing style may have affected the health of famous people such as Charles Darwin, Alexander Pope, Howard Hughes, Napoleon, Florence Nightingale, Frederick Matthias Alexander, Queen Anne, John Keats, and Moliere. That information is dispersed throughout the book and can be located by referring to the index at the back. M.B.