Two stories from ancient Greek mythology about jobs that, at first glance, seem impossible.
The twelve labours of Hercules or dodekathlon (Greek: δωδέκαθλον, dodekathlon) are a series of episodes concerning a penance carried out by Heracles, the greatest of the Greek heroes, whose name was later romanised as Hercules. They were later connected by a continuous narrative. The establishment of a fixed cycle of twelve labours was attributed by the Greeks to an epic poem, now lost, written by Peisander, dated about 600 BC.
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Fifth Labour: Augean stables
Heracles cleaning the Augean stables (mosaic from Roman Spain, 201–250 CE)
Main article: Augeas
The fifth Labour of Hercules was to clean the Augean stables (pronunciation: /ɔːˈdʒiːən/). This assignment was intended to be both humiliating (rather than impressive, as had the previous labours) and impossible, since the livestock were divinely healthy (immortal) and therefore produced an enormous quantity of dung. These stables had not been cleaned in over 30 years, and over 1,000 cattle lived there. However, Hercules succeeded by rerouting the rivers Alpheus and Peneus to wash out the filth.--Wikipedia, "Labours of Hercules" accessed 12 August 2012
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Source: http://upload.wikimedia.org/wikipedia/commons/9/99/Mosaico_Trabajos_H%C3%A9rcules_%28M.A.N._Madrid%29_05.jpg accessed 12 August 2012
Psyche searches far and wide for her lover [the god of love: Cupid in Latin, Eros in Greek], finally stumbling into a temple where everything is in slovenly disarray. As Psyche is sorting and clearing the mess, Ceres (Demeter to the Greeks) appears, but refuses any help beyond advising Psyche that she must call directly on Venus [Latin name for the Greek goddess Aphrodite, goddess of beauty and love], who caused all the problems in the first place [because she was jealous of any woman with whom her son fell in love]. Psyche next calls on Juno (Hera to the Greeks [queen of the pantheon of Olympic gods]) in her temple, but Juno gives her the same advice. So Psyche finds a temple to Venus and enters it. Venus [knowing that this is an impossible task] then orders Psyche to separate all the grains in a large basket of mixed kinds before nightfall. An ant takes pity on Psyche, and with its ant companions, separates the grains for her.--Wikipedia, "Cupid and Psyche" accessed 12 August 2012
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Source: http://upload.wikimedia.org/wikipedia/commons/2/23/Bouguereau-Psyche.jpg accessed 12 August 2012
The previous post provided access to some powerful tools, with real protential for problem-solving: taxonomic classification and ontological knowledge structures.
There's a common saying that the first step in solving a problem is admitting that it exists.
Does anatomical science have any major structural problems? Jacobs has identified what she considers a very serious one; let's look at the situation and its context to see what we're dealing with here.
Jacobs' problem is this, in her own words:
I had noidea that "fascia" meant, or was synonymous with, anything other than some sort of gluey stuff extruded from sparsely located cells, barely metabolically active except for cranking out vast amounts of sticky molecules, a trick that comes in handy in a heterogenous organism which has some parts hugely expensive to maintain (e.g. nervous system, only 2% of the body but requiring 20% of all the fuel), important for keeping an organism from falling apart, and for giving its more active contractile elements a place to anchor.
My idea of superficial fascia was that it was that fine filamentous spider-webby areolar stuff adhering the hypodermis on to the outside of the body, and to the dense fascia that overlies it. I confess, it was my conjecture, based on what I think is logical.
Now here is Gray's, saying it means hypodermis. Something is definitely wrong on the internet. Something might be seriously wrong in anatomy!
It seems to me Gray's is calling all animals in this layer cows, instead of just some animals. I look at this with jaw resting on floor. I really do think it amounts to a taxonomic error on the part of anatomists. I'm calling them on it, right here.
I think the term "fascia" should be left as a description of a particular connective tissue type, not an assemblage of tissue types that obviously comprise an organ, hypodermis, that has a particular function, i.e. thermoregulation, and through which passes indisputable neural structure which can't be classified with fascia no matter how hard you try to stretch it! (..no pun intended.)
The world of manual therapy is like a spaceship. And I feel like I just discovered the conceptual hole in the hull.
Because of this one single factual misnomer, countless generations of manual therapists have been sucked out into space, have had their minds snapped shut while simultaneously being made to contemplate the bogus idea that they have magical hands that can somehow overcome the logical purpose of fascia, which is to keep the body from coming apart, all because of a careless slip of taxonomic nomenclature stemming from the dissection habit anatomists have of slicing this blubber layer right off so as to get to viscera etc., useless and hindering as it is in a cadaver specimen, not investigating it from the perspective of how it might respond in a living human when touched from the outside, say by a manual therapist, who clearly cannot get his or her hands past the barrier of the heavily innervated outer dermis (not without introducing infection, at least), or past reflexive motor guarding by spinal cord function via autonomic and somatic motor efferent, and visceral afferent neurons. And it has been replicated, as a meme, as an error, by anatomists, apparently with high fidelity.
So, based on this careless anatomical overlook, manual therapists have been taught, carefully, in a stepwise, apparently anatomically acceptable but logically impossible Argument from Authority, a tissue-based myth that they can manually impact "superficial fascia", from the outside in!
To add further insult, this mistake (according to me at least!) has been allowed to sit there uncriticized, confusing generation after generation. When will the madness stop? It could stop immediately, if anatomists, or whoever is in charge of producing anatomical information, would just correct this one tiny assertion/conflation. It would be a necessary and sufficient hull patch.
Having worked with this anatomical information issue for some years now, I can assure everyone that it's not really as bad as Jacobs suspects.
It's much, much worse.
To sum up the problem concisely, as we head into the next parts, here's a reasonable (if minimalist) taxonomy of anatomical structures.
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As children of the same parent, "Anatomical entity", Anatomical structures and Anatomical spaces have some things in common that they inherit from that parent, and other things that differ from each other, which is why they are different kinds of Anatomical entity.
The same can be said for any subtree part of the larger tree--as children of the same parent, "Organ", Heart and Hypodermis have some things in common that they inherit from that parent, and other things that differ from each other, which is why they are different kinds of Organ. And so forth for different subtrees and branches of the larger ontology.
So far, no problem. What Jacobs perceives, correctly, is that if you replace "Hypodermis" with its synonym, "Superficial fascia", then the potential for serious confusion is introduced, as it looks as if "Superficial fascia" and "Deep fascia" form their own subtree of a parent fascia.
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So it's the same material physical referent--only the name (term) has changed. However, the name has changed to something very confusing, and that confusion cascades into our anatomy education. That's Jacobs' "hole in the hull".
But it's not hopeless, no matter how much it may seem like the ancient legends of the Augean stables and the temple grains.
Like Psyche in the story, we will find help from unexpected sources. How to address this massive, urgent problem is an active and ongoing research area, and others working on this issue have things to offer us that we need without even knowing it.
There is so much to say about the work that is being done, and what it means for the current problems our anatomy education (such as the one Jacobs identified), that this post grew hopelessly long. So I'm splitting it into parts, and will put up each part as it is finished.