Mary Dalgleish

1. Introduction
When I began my studies in complementary therapies in 1997 anatomy and physiology quickly became my favourite subject, and I read every book on the topic that I could lay my hands on. I had studied human biology at school, but it was at a time when my interests lay more with what was going on outside my body than inside it! Later in life I experienced some health issues that prompted me to explore fitness, nutrition and complementary therapies. I sought the advice of various experts who inspired me to make small and gradual lifestyle changes. My health and sense of wellbeing greatly improved, and it felt empowering to start taking responsibility for my own health and to see how much of a positive difference it made. This led to me enrolling in several complementary therapies courses, all of which included an anatomy and physiology component that fascinated me, and opened my eyes to the wonders of the human ‘machine’ and how it works. I found it intriguing to think of the massive and complicated orchestration going on inside my body every second of my life, without me having to give it a second thought.
After I qualified in a range of complementary therapies, including aromatherapy, reflexology and massage, I had an opportunity to use the teaching skills from my previous career to teach anatomy and physiology to complementary therapy students in several adult education centres and private colleges in London. Students would often arrive at their first class filled with trepidation about this subject, and I made it my mission to prepare classes that were interesting and engaging. Some body processes are extremely sophisticated and complicated e.g. the workings of the immune system, and many aspects of human biology are still being investigated. Scientific understanding of the human body is now much better than it used to be, but there are still mysteries to solve and new things being discovered. We are still learning more about immunity, the endocrine system, and about how the brain and nervous system function.
This book is a condensation of all the anatomy and physiology books I have read and the many lecture notes that I spent countless hours researching and preparing over my twenty years of teaching this subject. My students often complained about the size and weight of their textbooks, so I wanted to create a book that is easy to carry around and also not too expensive! I didn’t want it to look or read too much like a textbook, but at the same time I wanted it to be very comprehensive and include up-to-date information on topics such as fascia, scar work, current diseases like metabolic syndrome and novel viral infections, as well as topics that interest me personally such as telomeres, genetics, psychoneuroimmunology and the gut-brain axis.
Many people know more about how their car works than about how their body functions, so I wanted the information to be presented in a very accessible way that can be understood and enjoyed not just by students, but by anyone interested in knowing more about the workings of their own body. People rarely skip their vehicle’s maintenance requirements as they know this can have an adverse effect on its performance and longevity on the road, and the exact same can be said about the human body. The more we know about its inner workings, the better placed we are to look after its needs and optimise its function. I was particularly inspired by J.D Ratcliff's articles using the "I am Joe's Body" format in the Reader’s Digest which my parents used to get when I was a child. I found these articles very readable and easy to understand and they sparked my initial interest in human anatomy and physiology. I managed to get a copy of a paperback containing a collection of these articles with some black and white illustrations, and decided to use a similar angle when writing this book.
In writing the chapters, I imagined I was standing in front of my students and explaining the workings of the body in a way that was understandable and accessible, but still detailed enough to address what they needed to know for their exams. I recalled some of the many questions I was asked and addressed these as clearly as I could. I referred to the anatomy and physiology syllabi of major UK exam boards as these are mapped to current national occupational standards, and I made sure to address all the topics listed on those syllabi. I hope you enjoy reading my guide to human anatomy and physiology and that you will find it engaging, entertaining and educational without being overwhelming.
Although I wrote this book primarily for holistic therapy students who need to study anatomy and physiology as part of their training, I hope that it will appeal to others such as yoga students and teachers, fitness instructors, therapists of all modalities wishing to refresh their knowledge, or anyone wanting to know more about the workings of their body. The terms ‘complementary’, ‘alternative’ and ‘holistic’ are often used interchangeably and I am sometimes asked what these terms mean, so I hope this explanation of complementary, alternative and holistic healthcare and how it sits alongside conventional medicine will be helpful.
According to a 2017 report by the UK’s College of Medicine, around 9 million people in the UK use some kind of complementary or alternative medicine - often referred to as CAM. The growing awareness and use of complementary and alternative therapies has not gone unnoticed, and as far back as November 2000, a House of Lords Select Committee in the UK reported “the use of complementary and alternative medicine is widespread and increasing across the developed world.” Even though they are frequently grouped together in one category, a distinction should be made between complementary and alternative medicine. Complementary therapies do not focus on diagnosing or curing disease, but can be used simultaneously with conventional medicine to reduce side effects and stress and to increase wellbeing. Alternative therapies such as osteopathy, chiropractic, acupuncture, herbal medicine and homeopathy have an individual diagnostic approach, and can in some instances be used in place of conventional medicine, although they are used more frequently in a complementary capacity.
The Select Committee proposed three groups of CAM therapies with the above five disciplines regarded as the “most organised” professions. Osteopathy and chiropractic have statutory regulation in the UK, while the others are at various stages of regulation. The second group contains bodywork therapies that do not embrace diagnostic skills, and are most often used to complement conventional medicine. Examples of these are massage, reflexology, aromatherapy and other touch therapies. The third group includes other disciplines that offer diagnostic information as well as treatment and which, in general, “favour a philosophical approach and are indifferent to the scientific principles of conventional medicine” according to the report. These therapies are split into two sub- groups: group 3a includes long-established and traditional systems of healthcare such as Ayurvedic medicine and traditional Chinese medicine, and group 3b covers energy based disciplines e.g. energy therapies such as crystal therapy, iridology, radionics, dowsing and other therapies. The report also stressed the issues of public health policy raised by the growth of interest in CAM, and recommended research, adequate information and sound practitioner training to ensure safety of treatments available to the public.
With these aims in mind, The Prince of Wales Foundation for Integrated Health published ‘Complementary Healthcare, a Guide for Patients’ in February 2005. The aim of this guide was to help members make informed choices about complementary therapies and to find properly trained and qualified practitioners. The Prince of Wales Foundation for Integrated Health (originally named the Foundation for Integrated Medicine) was formed in 1993 at the personal initiative of His Royal Highness, The Prince of Wales. Its aim was to facilitate the development of safe, effective and efficient forms of healthcare to patients and their families by supporting the development and delivery of integrated healthcare. This means encouraging conventional and complementary practitioners to work together to integrate their approaches.
Following on from this, the Complementary and Natural Healthcare Council (CNHC) was founded in 2008 and became fully operational in early 2009. The aim of the CNHC is to protect the public by providing an independent UK register of complementary healthcare practitioners, accredited by the Professional Standards Authority for Health and Social Care - an independent body accountable to the UK Parliament. The aim of the register is to support the use of CAM therapies as a uniquely positive, safe and effective experience.
Since then, many UK professional associations for CAM therapists have set up their own Healthcare Therapist Register, accredited by the Professional Standards Authority for Health and Social Care. Accreditation by this independent body demonstrates that a voluntary register is managed effectively and adheres to good practice. It enhances public protection and enables service users, employers, healthcare commissioners and the public to choose a CAM practitioner who is competent and behaves in an ethical and compassionate manner. For example, the Federation of Holistic Therapists (FHT) - the UK's largest professional association for therapists - holds such a register, and its members adhere to a strict code of professional practice.
CAM therapies are sometimes referred to as holistic therapies due to the fact that the CAM approach considers the whole person - body, mind, spirit and emotions - in the quest for optimal health and wellness. According to holistic philosophy, the best way to achieve optimal health is by having a proper balance in life. Holistic practitioners believe that the whole person is made up of interdependent parts, and if one part is not working properly all the other parts will be affected. In this way, if people have imbalances (physical, emotional or spiritual) in their lives, it can negatively affect their overall health.
A 2015 Commission in the UK estimated that about 20% of patient consultations with medical professionals were for social problems rather than medical problems, and so the idea of a new initiative called ‘social prescribing’ was born. Social prescribing is when health professionals refer patients to support in the community in order to improve their health and wellbeing. This holistic concept has gained support in the UK’s National Health Service (NHS) as well as in other countries e.g. Ireland and the Netherlands. The goals of social prescribing are to reduce the rise of healthcare costs and ease pressure on general practice (GP) clinics by referring patients to a range of local, non-clinical services. It recognises that health can be determined by a range of social, economic and environmental factors, and seeks to address people’s needs in a holistic way, supporting individuals to take greater control of their own health. Social prescribing schemes involve a variety of activities that are typically provided by voluntary and community sector organisations. Examples include volunteering, arts activities, group learning, gardening, befriending, cookery, healthy eating advice, and a range of sports and other activities.
There are many different models for social prescribing, but most involve a link worker or navigator who works with people to access local sources of support. The Social Prescribing Network, which oversees this initiative, consists of health professionals, researchers, academics, social prescribing practitioners, representatives from the community and voluntary sector, commissioners and funders, patients and citizens, all working together to share knowledge and best practices to support social prescribing at a local and national level, and to inform good quality research and evaluation. It is an innovative and growing movement in the UK with the potential to reduce the financial burden on the National Health Service and particularly on primary care.
In a document published by the UK’s Department of Health & Social Care in November 2018 entitled ‘Prevention is better than Cure – our vision to help you live well for longer’ the Rt. Hon. Matt Hancock MP, Secretary of State for Health and Social Care, stated “Securing our nation's health requires a significant and sustained effort to prevent illness and support good physical and mental health. We need to see a greater investment in prevention - to support people to live longer, healthier and more independent lives, and help to guarantee our health and social care services for the long term.”
In the UK, we have several organisations helping to promote a holistic and integrated healthcare agenda. One example is The College of Medicine headed up by Dr. Michael Dixon LVO, OBE, FRCGP, FRCC who says: “We advocate for a new attitude to healthcare: one which forges partnerships across society, emphasises prevention and a multi-faceted approach, and empowers a healthier, happier population. We think everyone should be part of the conversation about health, not just a select professional elite.” Another is the King’s Fund, an independent charitable organisation working to improve healthcare in England, with a vision that the best possible health and care is available to all.
A report in December 2018 by the All-Party Parliamentary Group for Integrated Healthcare PGIH (now called the Integrated Healthcare Collaborative) states: “The future of healthcare lies in our health system recognising that physical, emotional and mental health are intrinsically linked, and that only by treating a patient as a whole person can we tackle the root cause of illness and deal with the problem of patients presenting with multiple and complex conditions.” The Integrated Healthcare Collaborative (IHC) is a collection of leading professional associations and stakeholders within complementary, traditional and natural healthcare, working together on common areas of interest to increase access to these therapies, promote greater integration with conventional Western medicine, and improve patient outcomes.
I was honoured to be a guest speaker at the second Integrative Health Convention in London in 2019. The audience at this 2-day convention on Complementary Health & Integrative Medicine included conventional medical practitioners, i.e. doctors, nurses as well as complementary and alternative therapists and members of the public. It is hoped that this will be an annual event, with the aim of integrating the knowledge and skills from complementary and conventional healthcare and using them to the advantage of all.
I hope that my little book will help educate people about the wonders of the human body, and inspire them to get the best out of this valuable machine. As Benjamin Franklin once said: “An ounce of prevention is worth a pound of cure.” (Although he was apparently referring to fire safety at the time!)
At the back of this book you will find a list of all the textbooks I referred to in my research. Nowadays we are lucky to have such a wealth of information online at our fingertips, and I have also included a list of all the websites I found useful in my research. There is a list of general references as well as references pertaining to each chapter, so that you can check out any studies or articles I have referred to in a specific chapter.
I have also created an accompanying “Know your Body” Workbook, full of tests and quizzes for use alongside this book, and do keep in touch for my “Know your Body” online course and audiobook, which are in development!
2. A Message from the Body
Some say I am the most fantastic machine in existence, because unlike most machines that can only do one or two jobs at a time, I can perform many tasks simultaneously - and I’m going to let you in on my secrets! Unlike other machines, I don’t come with spare parts, so I hope this book will inspire you to do everything you can to keep me running in tip-top condition. My basic needs are quite simple - good quality fuel in the form of nutritious food, pure water, rest, exercise (and some fun!), will keep me operating smoothly and prevent me from getting gunged up and breaking down unnecessarily.
The study of the structure and relationship between my body parts is termed ‘anatomy’ while ‘physiology’ is the study of how all these parts function together. ‘Pathology’ looks at the causes, mechanisms and consequence of dis-ease that impairs my normal functioning and typically manifests with various ‘abnormal’ signs and symptoms. ‘Homeostasis’ - homeo (unchanging) + stasis (standing) - refers to my ability to seek and maintain a condition of internal equilibrium or stability when dealing with external changes. For example, I sweat to cool off during the hot summer days and I shiver to produce heat when I’m cold.
At a chemical level, I’m made up of tiny building blocks called atoms – apparently around 7,000,000,000,000,000,000,000,000,000 (7 octillion) as an adult! Atoms such as carbon, hydrogen, oxygen and nitrogen are essential for keeping me alive, and combine to form molecules such as fats, proteins and carbohydrates. These molecules then combine to form cells, which are my basic structural and functional units. I am made up of many different types of cells, each with specific functions, but more about that later!
My cells combine to form four tissue types – epithelial, muscular, connective and nervous - and my various organs are composed of at least two types of tissue - for example, my heart is made up of all four tissue types. Organs with a common function make up my systems that perform particular activities - for example, my digestive system is composed of organs such as the stomach, liver, pancreas, small intestine and large intestine, and it functions to break down and digest my fuel (food). All of my systems combine to form me - the human organism.
My body systems include the integumentary, skeletal, muscular, cardiovascular, lymphatic, respiratory, digestive, nervous, endocrine, urinary and reproductive systems. Each of my systems depends on the others - either directly or indirectly - and they all interrelate to ensure that I function normally. My integumentary system, composed of my skin, hair and nails, protects my internal structures from damage, stores fat, prevents dehydration and produces vitamins and hormones. The bones, joints, ligaments, tendons and cartilage of my skeletal system support and protect, giving me shape and form. My skeletal, muscular and nervous systems work together enabling me to move, while internal muscles enable my heart to beat and my organs and vessels to contract and relax for internal movement. My respiratory system ensures that I receive a steady supply of oxygen, which is delivered to all my cells and tissues by my cardiovascular system. My digestive system breaks food down into smaller particles that I can absorb, and these are delivered to all my cells and tissues by my cardiovascular system. My lymphatic and urinary systems both work to keep my body fluids healthy and balanced, as well as removing waste. My endocrine organs secrete hormones that regulate many internal processes including growth, homeostasis, metabolism, sexual development and reproduction. My brain receives information from all body systems to ensure my proper functioning, and my amazing nerves extend to all parts, including my muscles and internal organs. And just like the white pith inside a citrus fruit that holds all its cells and segments together, layers of connective tissue hold all my internal bits and pieces in place, running through my entire body from my head to my toes.