Philosophy: The Primary Respiratory Mechanism

In his own unique and very elegant style, Dr. Sutherland had identified the same self-healing mechanism discovered by Dr. Still. He named this collection of findings the Primary Respiratory Mechanism:

Primary – It is a system that comes “first.” It underlies all of life’s processes and gives dynamism, form and substance to all of anatomy and physiology, driving all functions of the body.

Respiratory – It is the spark that gives rise to the breath as it moves through the tissues. It is the foundation of metabolism. It enables the exchange of gases and other substances between cells and compartments of the body.

Mechanism – It manifests as a specific motion of the body, a system composed of many parts that work together to create a whole, greater than the sum of the parts.

This Primary Respiratory Mechanism has five basic components:

1. The fluctuation of the cerebrospinal fluid (CSF) that bathes and nourishes the brain and spinal cord, and the Potency of the Tide.

2. The inherent rhythmic mobility of the brain and spinal cord.

3. The shifting tensions of the membranous envelope (dura mater) surrounding the brain, cranial bones and spinal cord. This entire membranous structure acts as a unit and is called a “Reciprocal Tension Membrane.”

4. The inherent rhythmic motility of the cranial bones.

5. The involuntary motion of the sacrum (tailbone) between the ilia (hip bones).


As the lungs breathe and the heart beats with a rhythmic alternating expansion and contraction, the central nervous system (CNS) also has its own involuntary rhythmic motion. Dr. Sutherland described this inherent activity of the CNS as a respiratory motion with “inhalation” and “exhalation” phases. The hands of a skilled osteopathic physician connect directly with the primary respiratory mechanism to bring about a therapeutic response. Primary respiration is the guiding principle; it is the inherent intelligence within. This Primary Respiratory Motion actually expresses itself through every cell of the body, influencing all body functions. Physicians trained in Cranial Osteopathy can place their hands on any part of the patient to perceive and influence this important mechanism.

Cranial Osteopathy is the study of anatomy and physiology of the cranium and its inter-relationship with the body as a whole. It may be applied for the prevention and treatment of disease and enhancement of health, within the practice of the science of osteopathy.