It may be taken as generally true that the study of anatomy has been viewed from the standpoint of the dissector who has aimed to provide information and guides for the operating surgeon. From the study information has been derived describing the artificially separated specific uses of muscles, and occasionally attempts appear to have been made to answer the very simple question as to what part the musculature described in formal anatomy takes in living processes. It must be evident that an answer to this question cannot be given by that study of anatomy which is conducted upon the cadavre, and that such study, while having its uses as a means of approach must be subordinated during the process of its interpretation to studies upon living processes. If the data of formal anatomy is looked upon as the dismembered bricks of an edifice, and if then the edifice of living man is examined to discover how these bricks are built together to produce achievements of differing architectural perfection, new considerations move the, view point of the examiner in assessing the meaning of the data of formal anatomy.

Here it is necessary to define the expression, architectural perfection, used above. In human beings, as in all animals, this may be defined as that just equation between the constructional elements which permits the least hurtful functioning of all processes within the creature, together with these functionings directive upon processes without the creature, upon which the creature satisfies its needs, provided always that these equally cause least hurt to all involved mechanism.

Two important discoveries in the last thirty years have led to vantage points from which anatomy can be re-viewed. Firstly, the late Rudolph Magnus of Utrecht revealed that the use of the head and neck in relation to the torso conditioned uses throughout the body. Written anatomically this would be thus-that groups of muscles in their working as well as adjusting the relation of parts to parts do work which is, in fact, a linking in a chain without which assumedly specific action in more ultimate parts could not occur.

Secondly, and more important than Magnus, F. Matthias Alexander of London, studying living men and women in use, observed that, although all human beings were provided with the same mechanism, divisible into anatomical elements, these elements in use showed a diversity of structure as elements and as a means to produce human edifices of bewildering variation. The observation was not of similars varying in magnitude, for that was an observation to be expected and accepted as in the course of things, but of similars directed without law to utter dissimilarity.

From his studies Alexander was able to deduce certain conclusions which anatomically may be written thus: that there were certain functions certain groups of muscles could not be considered to perform, although human beings so used them, and for the reasons that, firstly, from such use obvious hurt resulted to the mechanism in part or whole, or, secondly, functions in ultimate parts were hindered or stopped.

Proceeding further he discovered that, by using that function of the central nervous system called inhibition, certain usages of groups of muscle could be stopped, whereupon the remaining usages of these groups could be used both to produce movements of parts about joints and maintain relations of parts to parts with least function.

Essentially he discovered that these usages of groups of muscles lying in the neck posterior to the spine were those that first must be inhibited before it was possible to permit all groups of muscles to perform movements of parts about joints, and maintain relations of parts to parts, with least friction.

Viewing anatomy in the light of these discoveries it is seen that the function of muscles is twofold-namely, movement of parts about joints, and directive of part to part.

From this new view point the elements of anatomical knowledge can be examined to discover what muscles act at which sites in this two-fold capacity.

The skull is seen to rest upon the atlas by two articular facets. The muscles passing from the atlas to the skull are the two superior obliques behind, the two recti capitis anterior, and the two recti capitis lateralis in front. These groups of muscles acting antagonistically, in addition to producing extension, flexion, lateral flexion and rotation of the head on the atlas, according to their attachments determine a relation of the skull to the atlas which is a constant, while ultimate movements of the head and atlas upon the axis and further ultimates are performed. This constant can only be permitted to exist when no unjust pulls of more ultimate groups of muscles exist. It may be asked, what is the measure of the constant which is the relation of the skull to the atlas? This can only be answered by pointing to that measure which is left when all more ultimate groups of muscles attached to the skull are observed to be acting co-ordinately and with no unjust pulls.

Passing down the spine the recti capitis posterior are seen to arise from the second cervical spine to be inserted into the occipital bone. The antagonists to these muscles are the longi capitis which pass from the 3rd, 4th, 5th and 6th transverse processes to the inferior surface of the occipital bone, anterior to the foramen magnum.

This combined group of muscles produces extension, lateral flexion, rotation of the head, and flexion, and also that constant which is the relation of the head to the atlas.

The inferior obliques relate the axis to the atlas, and the axis to the skull-and-the-atlas already related by prior groups described above.

Anatomically it should be possible to arrive at a measure, primarily in a crude degree, of the physiological relationship that ought to exist between the skull and the atlas, and atlas and axis, by an examination of the articular facets of cadavres related to living postural antecedents. Articular facets from extreme pathological instances should write the extremes of misuse, and, by the process of departure from the faulty through less and less extreme instances the direction of perfect architecture could be sought.

Passing down the spine, the semispinalis capitis muscles pass from the transverse processes of the upper six thoracic, and the articular processes of the lower four cervical vertebrae to be inserted into the medial impression on each side between the superior and inferior nuchal lines of the occipital bone.

These muscles are concerned with the rotation of the head on the spine, the muscle of the one side antagonising that of the other. They also act together as extensors of the cervical spine against the flexion due to gravity which takes place, from the position of the seventh cervical spine. In addition this muscle determines a relation between its points of origin and the line of its insertion in the skull. As will be seen it has no antagonist anterior to the spine, and, so far as it maintains a relation of its points of origin and insertion, its antagonist is that group of muscles already referred to which make up the atlas-occipital, axis-occipital, and atlas-axis group, taken altogether as a unit.

That is to say that if the semispinalis with any other muscle group of a similar kind (splenius, trapezius) were to be used as retractors of the head or depressors of the head on the spine, they would be acting outside the limits of their function, since their function is rotation, extension, and the relating of certain points, while the primary spino-occipital group are performing their directive function.

More laterally, the splenius arises from the ligamentum nuchae (from the 4th cervical downwards) and from the spines of the last cervical and higher thoracic vertebrae, and is inserted on either side into the mastoid portion of the temporal bone and the lateral part of the superior nuchal line of the occipital bone. The action of the splenius of one side is antagonistic to the splenius of the other in rotation of the head and lateral flexion. In addition the splenius maintains a relation between its points of origin and its points of insertion in the skull. As will be seen it has no antagonists anterior to the spine, and, so far as it maintains a relation of its points of origin to its points of insertion, its antagonist is that group of muscles already referred to which makes up the atlas-occipital, axis-occipital, atlas-axis group, all taken together as a unit.

Continuing the same process of reasoning but without detailing, for the sake of brevity, the origins and insertions, the same comments may be applied to the sterno-mastoid and trapezius muscles.

An examination of a schema of the base of the skull showing the plotting of all muscles therein will show that, while there is a preponderant mass of muscles inserted posterior to the foramen magnum, there is, anterior to the foramen magnum, a very feeble grouping of muscles. Observations of the living subject will at once reveal that the common misuse of the semispinalis capitis the splenius capitia, the sterno-mastoid, and the trapezius muscles leads to a retraction and depression of the back of the head, and an overbalancing of the primary group of muscles whose function is to maintain the relation of the head to the cervical spine.

By such misuse all ulterior relations of portions of the spine to portions of the spine are thus disturbed. Relations of the head to the shoulder girdle, of the spine to the thoracic cage, of the spine to the scapulae, of the spine to the pelvis, of the shoulder girdle to the arms, of the pelvic girdle to the legs, are likewise disturbed.

Basically it becomes essential that anatomy shall recognise that the relationing function of muscle is the primary function of muscle, and that movements of parts upon parts is secondary.

Secondly, it must be recognised that the primary relation upon more ultimate relations depend is that relation established by the small group of muscles which comprise the atlas-occipital, axis-occipital, atlas-axis system.

The stupendous importance of this relationing function of muscles cannot be realized by the mere description of its existence. The failure to recognize the conception is charged with a heavy responsibility, since it means the approach to all living and human endeavour with but an imperfectly formed knowledge of physiological means.