SOUND THERAPY 201 - Biological Mechanisms (2023)

Por John Stuart Reid

Introduction

The intent of this article is to provide an introduction to some of the many biological mechanisms advantageously activated by sound and music, collectively categorized as "vibrational medicine." Since the development of quantum physics in the 20th century, discoveries in medical physics reveal the body as a complex interaction of biofields1 in which energy-information flows throughout the organism. At the cellular level, information is exchanged through electromagnetic signals, primarily in the far infrared spectrum, in addition to biochemical signals and sonic frequencies.2 At the atomic level, the biological complexities and flow of energetic information can be seen in terms of vibration. . Nobel Prize winner Max Planck said:

“As a man who has dedicated his whole life to the most lucid science, to the study of matter, I can say the following, as a result of my research on atoms: There is no such thing as matter. All matter originates only by virtue of a forceWhat makes an atom particle vibrate?and it holds together this tiny solar system of the atom.”3 It is in this context that vibrational medicine has its roots: considering the energetic (vibrational) interconnection of the mind-body system. Practitioners of holistic medicine, or functional medicine4 as it is often called, review all aspects of the patient, including her emotions. In this expanded medical model, since the body is composed of vibrational energy, a wide variety of vibrational and energetic modalities are available to support the patient's physiology, including sound and music. Some of the physiological mechanisms initiated by sound therapy and music medicine are achieved. immersing the whole body in specific sound frequencies, or in music, either recorded or live. Other mechanisms, neurologically initiated, can be achieved by listening to specific sounds or music through headphones. , create Far Infrared (FIR) light, due to the atomic physics of inelastic sonic collisions. The infrared light created by sound and music is the reason why sound intensity is measured in watts per square meter 5 and why this light is amplitude modulated.bytherefore, sound carries the FIR component of sound energy information nearly 4 cm into body tissues.6 Since intercellular communication occurs primarily in the far infrared spectrum, the physics of light-sound interactions infers that the Sound-modulated light is transmitted to cells in the midst of their own 'language'.2 Before exploring the biological mechanisms underlying Sound Therapy and Music Therapy, it will be useful to provide clear definitions of these modalities and the related field of Sound Therapy. Music therapy.

Definitions of music therapy, music medicine and sound therapy

terapia musicalit is an accepted form of complementary therapy in many hospitals and clinics and can be defined as:"The evidence-based and clinical use of music interventions to achieve individualized goals within a therapeutic relationship by a licensed professional who has completed an approved music therapy program."7Music therapy is a proven modality, but limited in the sense that each patient requires a music therapist to work with. There are a large number of books and scholarly articles available on the subject of music therapy, and therefore it is not the focus of this article.Music MedicineIt can be defined as:“Listening to music [for healing purposes] without the presence of a therapist.”8 Music Medicine is a relatively new clinical modality that refers to the therapeutic use of music, chosen by the patient in a clinical setting without the intervention of a therapist. As its title implies, music medicine focuses on the demonstrable benefits of music as a treatment for specific health conditions. The mechanisms by which music affects body systems are complex, and this article provides a brief introduction to this topic.therapy where i amIt is defined by the International Sound Therapy Association as:“The application of audible sound to the whole body or to a specific part of the body, from electronically generated sound sources, or from musical sources, as therapeutic support, by a professional licensed in Sound Therapy”.9This definition clarifies that audible therapeutic sound can be generated electronically or provided by a musical source. The biological mechanisms triggered by such sonic support will be discussed later in this article. while the molecular biologist and pianist Emiliano Toso played a grand piano in the operating room.

doctor Emiliano Toso playing the piano in an operating room, during live neurosurgery

Monitoring of the child's brain activity via an encephalogram suggests that the child noticed the music. Doctor Toso said: "We tried stopping and restarting the music, watching the patient's response. Even though the boy was under full anesthesia, his brain seemed to perceive the music and that was very exciting." Doctor Trignani, head of the Riuniti Hospital's neurosurgery unit, commented: "Everything went well, there were no complications and there was a magical atmosphere of total harmony in the operating room." 10It is admirable and noble that musicians contribute their time and talent to play in hospitals. The harp, in particular, has a long history of use in clinical settings and nursing homes and will likely always form an important aspect of patient care. However, several commercial manufacturers have developed sound-based therapies that can help patients recover from illness and offer greater flexibility and comfort in clinical settings than live music.A brief description of some of the biological mechanisms activated by immersing the whole body in music or specific sound frequencies(Detailed explanations are provided later in this article.)

Total body immersion in music or specific sound frequencies (rather than listening through headphones) activates several beneficial biological mechanisms, four of which are briefly summarized below: • Increases nitric oxide (NO) production through the active and passive acoustic stimulation of the sinus cavities and lungs by specific sound frequencies and music, resulting in a wide range of health benefits. • Promotes pain mediation through stimulation of the body's large A-beta fibers or A-alpha fibers in the area experiencing pain, causing the pain gate to open. close.• Increases the availability of oxygen that binds to hemoglobin molecules through low frequency sound pressure, thus breaking the pain-spasm-pain cycle or 'immobilization cycle', increasing oxygen availability to affected tissues.• Activates the meridian system, through 'sound acupuncture', with many health benefits, including pain mediation and anxiety mediation. Listening to music or listening to specific sound frequency uences activates various biological mechanisms , four of which are briefly summarized below: (Detailed explanations are provided later in this article.) pain modulation. Such effects may be initiated by music (or white noise) as a result of endogenous opioid activation. • Promotes stress reduction with the consequent reduction in blood pressure and cortisol levels, and induces a state of happiness with the consequent increase in dopamine levels, which leads to a proliferation of leukocytes, thus increasing the effectiveness of the immune system.

• Stimulates the brain binaurally, through binaural beats, to create changes in the state of the brain with physiological benefits. • The vagus nerve is stimulated, regulating internal organ functions, including digestion, heart rate, and respiration, as well as promoting vasomotor activity and anti-inflammatory effects. Specific very low (subaudible) frequencies can also be applied with full headphones, combined with music. Each of these biological mechanisms will be discussed separately.

Active and passive sonic stimulation of the sinus cavities and lungs

Before discussing the method of sonic stimulation of the nasal cavities and lungs, it is important to highlight some of the natural health benefits of nitric oxide (NO).,It occurs naturally in many areas of the body, including the cilia in the sinus cavities and the alveoli in the lungs. NO reduces blood pressure by vasodilation11 and many other health benefits derive from this important molecule, for example:promote wound healing through cell proliferation and angiogenesis,12mediation of edema and inflammation of the skin,cytotoxic action against pathogens,13increases cerebral blood flow and oxygenation of the brain,14inhibits platelet aggregation within blood vessels, helping to prevent thrombotic events,15 supports reduction of pulmonary hypertension and chronic obstructive airway disease.sixteen

Nitric oxide relaxes smooth muscle cells in the walls of blood vessels, leading to vasodilation (Courtesy of NIOX)

NO can be produced in the body from inorganic nitrates in fruits and green leafy vegetables, particularly by the oral microbiome 17 and is also stimulated by exercise, 18 which can be part of a rehabilitation program, but the initial approach in this section is NO production in sinus cavities elicited by active and passive sonic stimulation. 'Active' stimulation refers to the practice of humming, which has been shown to greatly increase NO production.19,20 The movement of air across the cilia in the sinus generates NO, from which many benefits are derived for health, although the exact mechanisms by which NO is produced by the cilia are not fully understood.21 The practice of nasal breathing is well known in the yogic practice of pranayama, which means 'breath control' in Sanskrit. , a practice that is mentioned in the Bhagavad Gita, written sometime between 400 B.C. 200 BCE.22 In an article titled,Assessment of nasal and sinus nitric oxide production by humming a single breath,23 the authors show that NO increases significantly with a single expiration while humming, as shown in the graphic.

Original trace of nitric oxide during a single-breath nasal expiration with (dotted line) and without (solid line) tinnitus

The authors of this study also performed experiments to determine optimal tinnitus frequencies and concluded that a measured frequency of 130 Hz created the largest NO output from the sinus cavity in a human subject. The study does not specify whether the

the human subject was male or female, but in both cases the result is surprising when remembering that the sinuses consist of relatively small cavities, presenting Helmholtz resonance frequencies in the range of 1 kHz to 2 kHz,24 depending on sex and age of maturity. The resonant frequencies refer to the ancient Egyptian use of the sistra instrument, the metal disc rattle, mentioned in the author's Sound Therapy 101 article. At the Opet Festival, the sistra was used to stimulate the nostrils:'Make the sistra present in your nostril so that it can give you a rejuvenating breath...'25 a statement suggesting that the ancient Egyptians knew that the sistra emitted a specific quality of sound that had a rejuvenating effect on the nasal cavities. The skulls and nasal cavities of adult females are usually smaller than those of adult males.;Smaller sinus cavities support higher resonant frequencies. It should also be remembered that tinnitus does not generate a single frequency, but rather gives rise to a series of harmonics and that the main resonance mode of the sinus cavities is automatically 'selected' during vocal tinnitus as a natural aspect of the Helmholtz resonance. (the resonant resonance). property of a gas-filled cavity). Therefore, although the fundamental hum frequency of maximum excitation was 130 Hz, (in the studyAssessment of nasal and sinus nitric oxide production by humming a single breath) the nasal cavities would surely have been excited by a specific harmonic of that frequency. Nitric oxide is also generated by the alveoli of the lungs26 and can be stimulated by active and passive sonic stimulation; actively by humming or singing, and passively by externally applied sonic frequencies or music. Guidance on the optimal frequencies for passive stimulation can be obtained from studies in which the respiratory system was modeled in terms of its resonant sound characteristics.27,28 In the University of Illinois study27, it is shown that the resonant frequency of Helmholtz of a healthy volunteer is of the order of 100 Hz, rising to about 250 Hz for a person with pulmonary fibrosis. These frequencies vary between individuals due to gender and lung capacity based on the genetic makeup of the patient. Likewise, the Helmholtz resonance frequencies of the sinus cavities vary between individuals.

It is not necessary to identify the precise resonant frequencies of the patient's lungs or sinus cavities to deliver a therapeutic intervention if the professional plays live or recorded music for the patient at a moderate to high sound level of 70 to 85 dBA. (It should be noted that live music contains much more high-frequency harmonics, effective for sinus stimulation.) A patient's sinus cavities or lungs will automatically choose the specific frequency at which the cavity naturally resonates, and this applies (for example) to musical instruments in situ, such as pianos, harps, gongs, singing bowls, crystal bowls and all the music recorded through hi-fi sound equipment.

Helmholtz resonancef = resonant frequency of the cavity, c = speed of sound in air, S = aperture area, V = volume of air in the cavity, L = tube length

In addition to stimulating nitric oxide production, acoustic stimulation of the sinus cavities and lungs can also help clear mucus and improve symptoms of chronic obstructive pulmonary disease (COPD) and chronic bronchitis.29

Mediation of chronic pain by audible sonic stimulation of nociceptors

Pain is a vital function of the body, providing an early warning of harm or potential harm. It is a sensory and emotional experience, affected by psychological factors such as past experiences, beliefs about pain, fear, or anxiety.30 Tissue injury, for example, initiates the release of various inflammatory mediators, including prostaglandins, cytokines, and chemokines. Leukocyte migration to the injured area, a feature of the inflammatory response, is associated with pain and tenderness and is involved in wound healing. is not within the scope of this article. Chronic pain is a common, complex, and distressing problem that has a significant impact on individuals and society.32 Chronic pain, like most illnesses, generally arises from a series or combination of several events.32 Biological processes Leading to the chronic pain state further increases sensitivity to painful stimuli and perceived levels of stress, further modifying pain-related gene expression, creating a pathological pain cycle. ), there are still a number of factors that affect the duration, intensity, and effects (physical, psychological, social, and emotional) of chronic pain.32 The International Association for the Study of Pain defines pain as 'A sensory and emotional experience unpleasant associated or similar to that associated with actual or potential harm'34 and chronic pain is 'pain that persists beyond the normal healing time'.35 Pain is considered chronic when it lasts for more than three to six months.36 Bearing in mind that pain is a universal experience, it is not understood why only a relatively small proportion of humans develop a chronic pain syndrome.37 Prolonged use of analgesics, like opioid use, is associated with constipation, sleep-disordered breathing, dysregulation hypothalamic-pituitary-adrenal, fractures (as a result of osteoporosis), and a significant decrease in health-related quality of life and increased costs care.38 Therefore, it would be advantageous to alleviate chronic pain without the prolonged use of analgesics. Unlike the long-term use of pain relievers, audible sonic interventions have no known adverse side effects.

Conduction of the nerve signal by sound.

In order to establish a basis for discussion of the principles of pain mediation by sound, it is important to mention the findings on the transmission of nerve signals by sound. In 1952, Alan Hodgkin and Andrew Huxley, working with the giant axons of a squid, described how action potentials (or nerve impulses) are initiated and propagated in neurons, now known as the Hodgkin-Huxley model. 39 It is considered one of the great achievements of biophysics of the 20th century, for which they received the Nobel Prize in Medicine in 1963. The flow of electrical currents in the nerves has become the standard teaching model in textbooks of medicine and biology. However, one aspect that intrigued the researchers was the relatively slow conduction velocities in nerves, compared to the conduction velocities of electrical currents in conductors. The speed of light in a vacuum is 2.998 × 108 meters per second, which is roughly equivalent to a distance of 30 cm per nanosecond. The speed of an electrical signal on a coaxial cable is about 2/3 of that, or 20 cm per nanosecond, so in one second the signal on a coaxial conductor will travel about 200,000,000 meters, which is a little more than the half the distance between Earth and the moon. Nerve fibers, by comparison, conduct signals several orders of magnitude slower than coaxial cables. The highest conduction velocities of nerve fibers are those of muscle axons, which can reach speeds of over 100 meters per second.

The main classifications of afferent nerve fibers and their conduction velocities, which are very slow compared to electrical currents in coaxial cables.

However, in 2005, researchers from the Niels Bohr Institute at the University of Copenhagen proposed a new model of nerve conduction, whose experiments showed that nerves conduct sound (soliton impulses), which in turn generate electrical pulses, due to the piezoelectric effect. . 40 In their article, they state that “…the measured propagation velocities, which are ~100 m/s in myelinated nerves, find a satisfactory explanation”. In other words, the propagation of nerve impulses by sound accounts for the slow conduction velocities, while these sonic impulses give rise to electrical impulses that travel to the brain for interpretation. This finding has significant implications for sound therapy and music medicine, particularly for whole-body immersion in music and specific sound frequencies.

Principles of pain mediation by sound

Nociceptors are the specialized sensory receptors responsible for detecting harmful (unpleasant) stimuli, transforming the stimuli into electrical signals, which are then conducted to the central nervous system.30 They are the free nerve endings of the primary afferent fibers and are distributed along body tissues, including skin, viscera, muscles, joints, and the meninges of the brain (but not the gray matter of the brain). The four main classifications of afferent fibers have specialized functions, for example, response to light, touch, or acute events, or response to chemical or thermal stimuli, but crucially all types of afferent nerve fibers respond to mechanical pressure. And since sound can be defined as: “Mechanical radiant energy that is transmitted by longitudinal pressure waves in a material…”41 it is clear that all types of afferent fibers respond to sound. This fact is reinforced by the discovery by the Niels Bohr Institute that nerves conduct sound as soliton pulses. When nociceptors are stimulated, nerve impulses are transmitted to three systems in the spinal cord: substantia gelatinosa cells in the dorsal horn; fibers from the dorsal column that project to the brain; and the first central transmission (T) cells in the dorsal horn.77

Cross section through the spine showing the dorsal root ganglion (Graphic: Emri Terim)

The theory by which sound frequencies can mediate pain is based on the 'Pain Control Theory', first proposed in 1965 by Ronald Melzack and Patrick Wall.42 The theory was initially met with skepticism, but despite After having undergone several modifications, its basic design is maintained. unchanged. His theory provides a neurophysiological explanation for pain perception and ultimately revolutionized pain research. The gate control theory proposes that there are gates between the afferent nerves and the brain, located in the spinal column, that control how pain messages flow from the peripheral nervous system to the central nervous system. Delta afferent fibers (detecting sharp pain) and small C-type afferent fibers (detecting dull pain) open the gate, resulting in pain perception in the brain. Stimulating large A-beta fibers or A-alpha fibers in the area that feels pain causes a reaction in nearby inhibitory neurons. Once activated, the inhibitory neurons, which are in the same pathway as the projection neurons, the gate closes, silencing pain signals before they reach the brain. Stimulation of A-beta fibers or A-alpha fibers can be achieved by specific sound frequencies, as mentioned below.

The Melzack-Wall gate control system (from Melzack and Wall) L = large diameter nerve fibers, S = small diameter nerve fibers. The fibers project to the substantia gelatinosa (SG) and to the first central transmitting cells (T). Activity in large fibers inhibits signals from small fibers. (Drawing by Ronald Melzack and Patrick Wall:Mechanisms of pain: a new theory.)

Some of the optimal frequencies considered beneficial for mediating pain through nociceptor stimulation were discovered in Finland by clinical psychologist Petri Lehikoinen, in the range of 27 Hz to 113 Hz. Lehikoinen developed a therapeutic system: Physio Acoustic Sound Therapy (PAS), which has been approved in the US by the Federal Drug Administration (FDA) and in the UK by the British Standards Institute (BSI) for three claims: decreased pain, increased blood. lymphatic circulation and greater relaxation and muscle mobility43. In Norway, Olav Skille has placed special emphasis on specific therapeutic frequencies of 40 Hz, 52 Hz, 68 Hz and 86 Hz43.

neurogenic pain

Pain that is not a consequence of nociception, categorized as “neurogenic” pain, can also occur as a result of arrhythmias or disconnections of the neural circuitry. However, neurogenic pain has been found to be mediated by vibratory analgesia as a result of cortical dynamics44. For example, in a study with fibromyalgia patients, positive effects were obtained due to oscillatory coherence, with vibrotactile stimulation of the body at 40 Hz. Four. Five

Downward inhibition of pain by music and white noise

A second pain-mediation mechanism, sometimes referred to as "top-down" pain modulation 46 but more accurately described as the "descending inhibitory system" 47 or "descending analgesia system" 48, can be activated by music that creates a strong emotional response. These emotions elicited by music can be described as “shudders.”49 Music offers a host of benefits without negative side effects and is therefore a favorable option for those seeking alternative pain management therapies.47 The origin of this second mediation of the pain mechanism. arose from an initial study by Dr. Henry K. Beecher, titledPain in men wounded in battlein which he observes: "Three quarters of seriously injured men, even if they have not received morphine for a few hours, feel so little pain that they do not need painkillers... Strong emotions can block pain." fifty

Ascending and descending pathways of pain (courtesy of walterskluwer.com)

Descending inhibition refers to tracts originating in the brainstem and terminating in the spinal cord to suppress sensory transmission and thereby produce analgesia.47 Music-induced analgesia is believed to occur as a result of the release of opioids during music listening,48,49 thus involving the descending analgesia system that creates antinociceptive responses in the spinal cord. The descending inhibitory pathways use endogenous opioids, hydroxytryptamine (5-HT), and norepinephrine, and their effects are mediated by supraspinal, midbrain, and brainstem circuits.51 A large number of brainstem structures suppress pain through projections that They descend to the dorsal horn of the brainstem. vertebral column and, in most cases, its descending pain suppressive effect is transmitted via the periaqueductal gray (PAG) and rostral ventromedial medulla (RVM). .47

Breaking the "pain-spasm-pain" cycle in spinal cord injury, through sound

The first suggestion of a pain-spasm-pain cycle is generally attributed to Janet Travell, who wrote in 1942: “If muscle spasm causes pain, and pain reflects muscle spasm, a self-perpetuating cycle may be established. ..”52 Today, it is well known that spinal injuries often create muscle spasms to “fix” the injury site, providing protection while the healing process takes place. In a round table among four doctors titled,Diagnosis and treatment of low back pain due to paraspinal muscle spasm: a medical roundtable, not published Journal of Pain Medicine, Dr. McCarberg states: “From an initial injury, the patient develops pain. Motor neurons fire as a reflex to immobilize this area causing muscle spasms. Muscle spasm clearly causes pain, but the exact cause of the pain is poorly understood. Regardless, this pain will cause more muscle spasms…Hopefully, if this cycle is stopped, it won't result in a chronic problem.” 53 Trauma caused by a spinal cord or other injury causes pain, which leads to muscle tension. A cascade of effects then ensues in which muscle tension decreases blood flow, which (hypothetically) leads to hypoxia and more pain in the affected muscles. The spasm then intensifies, causing the hypoxia to intensify and the pain to intensify, causing much more pain than the injury.

Pain > Muscle tension > Decreased blood flow > Hypoxia and pain > Intensified spasm > Intensified hypoxia > Intensified pain

Decreased blood circulation is believed to be a direct result of intramuscular blood vessel compression, a concept supported by the fact that blood supply to a muscle is known to decrease during voluntary contraction and pain afterward. from muscular exercise is very similar to pain induced by experimentally reducing the blood supply to a muscle.54

Pain relief and anxiety relief using acupressure and sonopuncture

Acupressure is an alternative medicine methodology that originated in ancient China; incorporating the effects of treatment by stimulating acupuncture points by strong pressure.55 The World Health Authority, in its 1991 Report on the International Nomenclature of Acupuncture, lists 14 main meridians and 361 classical acupuncture points, plus 8 additional meridians and 48 acupuncture points.56 These same classic acupuncture points, which can be activated by strong local pressure, can also be activated by sound, as sound (as mentioned above) can be defined as: “Energy mechanical radiant transmitted by longitudinal pressure waves on a material. .”41 This is the basis of 'sonopuncture', a therapeutic modality that is a type of acupressure. efforts. Clinical trials have shown that health professionals can effectively perform acupressure as an adjunctive therapy in general practice for pain relief.57 The authors also concluded that their systematic review article begins to establish an evidence base. evidence for the use of acupressure in pain relief and that a reliable and valid evaluation evidence base is crucial for clinicians. In terms of implications for nursing education, practice, and research, the review provides important evidence that acupressure uses a non-invasive, timely, and effective manner to support its efficacy in relieving a variety of pain conditions.57D. Carey, a licensed acupuncturist, developed a therapeutic method using frequency-specific tuning forks to activate acupuncture points while clinical director of the Northwest Institute of Acupuncture and Oriental Medicine in 1995. The intent was to seek a non-invasive therapy that could be taught to students and used in clinics with critically ill patient populations, including those suffering from HIV/AIDS, chronic pain, and trauma. fits many clinical specialties and can support patients seeking traditional Western medicine therapies.59

Sound puncture, self- or physician-applied, using tuning forks, courtesy of (Courtesy of Dr. E. Franklin)

Licensed acupuncturist, M.E. Wakefield, L.Ac., awarded "Educator of the Year" by the American Oriental Medicine Association in 2005, is co-author of VBracional acupuncture: integration of tuning forks with needles.com Michel Angelo, M.F.A., vibrational medicine consultant. His book uniquely explores the synergy of tuning forks and acupuncture. For the measurement of pain, by sonopuncture, the authors recommend the application of a 136.1 Hz tuning fork at specific acupuncture points. While sonic activation of acupressure points generally supports multiple interconnected body systems, the following examples focus primarily on pain mediation:

• Lu-7 Lieque, 'Broken Sequence' relieves headaches, sore throat, migraine, toothache, wrist pain.

• SI-3 Houxi, 'Back Stream' relieves neck pain, acute lumbar sprain, shoulder and elbow pain.

• UB-62 Shen Mai, 'Extended Vessel' relieves headache, back pain, leg pain, insomnia.

• TH-5 Waiguan, 'Outer Pass' relieves headache, facial pain, finger pain, hand tremors.

• Bl-58 Feiyang'Taking Flight' mediates sciatica pain, relieves headache and back pain.

Another important therapeutic use of tuning forks was discovered by E.D. McKusick, MA, author of the book,Tuning the human biofield.61 Energy information is constantly radiated from the body in the form of biofields, as mentioned in the first part of this article. Biofields include biophoton energy, for example, modulated infrared electromagnetism that is a natural consequence of cellular metabolic processes, as well as modulations in electromagnetic fields emitted by the heart, brain, and other organs. Quoting the foreword by Dr. Karl H. Maret, who practices Complementary and Alternative Medicine, “when a holographic sound field, such as that produced by a tuning fork, containing complex data structures of pure frequencies with varying phase relationships, interacts with In a person's biofield, cellular memories of various tissues can be awakened, potentially leading to a healing response. The quantum theory of physical fields predicts the occurrence of a series of coherent dynamic phenomena in liquid water within cells and tissues that can be stimulated by sound. This process affects the free electron clouds that exist in these coherent water domains, [thus modifying] cellular processes through their interaction with the hydration shells surrounding cell membrane receptors." The biofield adjustment method has been shown to consistently reduce anxiety and relieve pain.62

A therapeutic biofield tuning session in progress (Courtesy of E.D. McKusic)

Electronic device delivered sleep puncture pain relief

Although sonopuncture is generally applied using tuning forks, devices that emit low-frequency vibrations can also achieve sonic activation of acupressure points63 in addition to devices that emit ultrasound.64 Acupressure points on the soles of the feet can also Stimulate the meridian system by applying frequencies. sound.65 Dr. M. Cromwell developed a therapeutic device that uses a vibratory tactile transducer, which emits a range of audible sound frequencies into gel-filled acoustic pads on which the soles of the feet rest, thus stimulating the meridian system . Together with his assistant, Kate Holland, CCP, they conducted a six-week pain research study in 2016 with three subjects, a 30-year-old woman, a 38-year-old man, and a 68-year-old man. 66

Sound puncture delivered via vibrotactile transducer and gel-filled acoustic pads (Courtesy of Dr. M. Cromwell)

In summary, for this section on Acupressure/Sound Needling, there is significant potential for pain reduction, as well as support for a variety of other chronic conditions, including depression, PTSD, insomnia, and others.

Musical stimulation of the immune system (via headphones or full body immersion)

Any form of illness can cause emotional distress, and emotions can play an important role in a patient's recovery from illness or surgical procedure. Stress and fear cause the adrenal glands to release cortisol 67 , which helps prepare the body for "fight or flight" by providing additional glucose, tapping into protein stores through gluconeogenesis in the liver.68 However, cortisol also suppresses the immune system69 and other bodily functions. function systems considered by nature to be 'non-essential' in the short term, making the patient more vulnerable to contracting pathogens. While pharmaceutical sedatives are routinely prescribed to relieve a patient's stress and fear, music can produce a similar result without medication. Music, when played live for patients, provides full body immersion in a myriad of sound frequencies that have physiological and psychological effects.benefits Listening to music with headphones has a direct effect on the vagus nerve, as described below.Music can evoke happy memories of moments, places, or life events that can quickly turn a patient's mood into one of joy, a state in which the brain and enteric nervous system in the digestive tract produce dopamine, It stimulates the immune system. .70, 71 Parallel to the increase in dopamine, the patient's favorite music causes a reduction in cortisol levels.72 Joy also causes the pituitary gland in the brain to release beta-endorphins into the bloodstream, which produce analgesia by binding to mu opioid receptors that are present in all peripheral nerves. Mu opioid receptors have been identified inthe central terminals of primary afferent neurons, peripheral sensory nerve fibers, and dorsal root ganglia.73 The pituitary gland also stores the neuropeptide, oxytocin, colloquially known as the "love hormone." Oxytocin is produced in the hypothalamus and transported to large, dense-core vesicles in the posterior lobe of the pituitary gland,74 where it is released into the bloodstream in response during sexual activity and orgasm, as well as during childbirth. In a broader context, there seems to be a general consensus among studies that listening to music improves oxytocin synthesis75 and postoperative patients who listened to music through headphones demonstrated an increase in serum oxytocin and reported higher levels of relaxation, in comparison with a control group without music. 76 Oxytocin and its receptors appear to occupy the leading position among the candidates for the 'happiness' substance,77 and in a study focusing on autistic children, significantly lower levels of oxytocin were found in their blood plasma, suggesting a ray of hope in finding a role for oxytocin in the treatment of autism,77 that is, in both cases (evoking happiness and supporting autism treatment) there is an obvious link in the form of music, whether applied through headphones or full body immersion. and the immune system was reported in a 2019 study conducted by Univers Edad de Augusta, United States. The researchers found that when the mice were subjected to low-frequency sound vibrations, macrophages in their bloodstreams proliferated significantly.78 This effect has not yet been demonstrated in humans, however it seems likely that human blood responds in a similar way. to that of murine blood. The possible mechanism that enhances the proliferation of macrophages in blood immersed in low frequency sound is an increase inpagO2 level. It is important to mention that this aspect of the connection between music and the immune system would only occur during full body immersion, as the entire circulatory system would require stimulation by low sonic frequencies.

Binaural Beats (via headphones) to create brain state changes with physiological benefits

Binaural beats were accidentally discovered in 1839 by the Prussian scientist Heinrich Wilhelm Dove, during experiments with two tuning forks of different frequencies. He has been called "The Father of Meteorology" 79 for his work in this field; however, until 1915 his discovery of binaural beats was considered a trivial special case of monaural beats.80 Monaural beats occur when two sounds of slightly different frequencies are produced simultaneously. , resulting in a pulsating effect caused by the mixing of the two sounds, which strengthen when their phases align, and decrease when their phases oppose. But during headphone listening, when two slightly different frequencies are experienced, the composite frequency difference is known as the binaural beat and provides a mechanism to stimulate the auditory system at very low frequencies, below the frequency range of hearing.81 Listening to binaural beats produces the illusion that the sounds are located somewhere inside your head. The lower auditory centers of the brain are in the medulla oblongata, and impulses from the right and left ears first meet in the left or right superior olivary nucleus. These structures are part of the olive, an organ that, according to this view, is located behind the brain stem. Binaural beats are likely to be detected here.80 The difference in frequency between the sounds presented to the left and right ears drives the brain rhythms to that frequency.

Representation of binaural beats (Courtesy of Hemi-Sync®hemi-sync.com)

In a carefully designed, double-blind, crossover study of binaural beats titled:Binaural earbeats affect alertness, performance, and mood. Physiology and Behavior, 29 volunteers were tested. The recordings used in the study contained a pink noise background sound and a carrier tone, within which a different drag frequency was incorporated between the left and right channels. (The purpose of the pink noise was to mask the sound of the carrier tone.) The participants were blinded to the true purpose of the study and were unaware of the presence of binaural beats in the headphones. The results of the study provided evidence that the presentation of simple binaural auditory stimuli during a 30-min vigilance task can affect both task performance and task-associated mood changes. Effects on behavior and mood were seen in the absence of participant expectations, and the experimental control ruled out placebo effects. The authors concluded that simple auditory stimulation with binaural beats can influence psychomotor and affective processes, even when people are unaware that such cues are being presented, and that this technology may have applications for attention control and awareness. excitement and for the improvement of human health. performance. 81 In another double-blind crossover study titled:Pain reduction and analgesic use after acoustic binaural beats therapy in chronic pain: a double-blind randomized crossover control study, the authors concluded that binaural beats of theta rhythm reduced pain intensity, Stress and analgesic use, compared with sham stimulation, in patients with chronic pain. Another conclusion was that the subsequent significant reduction in the consumption of analgesic medications in the daily life of patients with chronic pain could offer a valuable tool, increasing the effect of existing pain therapies.82 Robert Monroe of the Monroe Institute created a system of binaural beats in which a combination of audio binaural beats mixed with music, pink noise and/or the natural sound of ocean waves is heard which has been called the 'Hemi-Sync' process. Studies with this system have shown improvements in sensory integration,83 relaxation, meditation, stress reduction, sleep and pain management,84 enriched learning environments, and improved memory.85

Sonic stimulation of the vagus nerve (through headphones) and by vocalizations

The vagus nerve represents the major component of the parasympathetic nervous system, which oversees a wide range of crucial bodily functions, including mood control, immune response, digestion, and heart rate, and carries a wide range of system signals. digestive and organs, and vice versa. . versa.86 Leaving the jugular foramen, an atrial branch is detached, providing innervation to the auditory canal and external ear. This is the only branch of the vagus nerve that reaches the head. As the vagus nerve travels down the neck through the medulla oblongata, branches branch to the pharynx and larynx before continuing to the thorax, where it connects to the heart and other major organs. The laryngeal and auricular connections are of special interest in the context of sound therapy and music medicine, which are discussed later in this section, after an overview of the vagus nerve and the methods of its therapeutic stimulation.

Vagus Nerve Branches and Functional Anatomy of the Inflammatory Reflex (Adapted with permission, Pavlov and Tracey 87)

Schematic description:

Activated macrophages and other immune cells release inflammatory mediators, such as cytokines, after immune challenge. These mediators are detected by sensory components of the afferent arm of the inflammatory reflex. Neural interconnections between NTS, AP, DMN, NA, and upper forebrain regions integrate vagus (red) and efferent (blue) afferent output, thereby regulating immune activation, suppressing proinflammatory cytokines86, and reducing inflammation. Vagus efferent output can be supported by atrial and laryngeal input. The bidirectional communication between the brain and the GI tract, sometimes referred to as the "brain-gut axis," is a complex system that includes the vagus nerve and is becoming increasingly important as a therapeutic target for gastrointestinal and psychiatric disorders such as intestinal inflammation. . illness, depression, and post-traumatic stress disorder.86 The gut is an important control center for the immune system, and the vagus nerve has immunomodulatory properties. As a result, this nerve plays an important role in the relationship between the gut, the brain, and inflammation.86

There is a hardwired connection between the nervous system and the immune system as an anti-inflammatory mechanism. Counterregulatory mechanisms, such as immunologically competent cells and anti-inflammatory cytokines, normally limit the acute inflammatory response and prevent the spread of inflammatory mediators in the bloodstream. The dorsal vagal complex responds to increased amounts of circulating tumor necrosis factor (TNF-α) by altering motor activity in the vagus nerve,86 therefore vagus nerve stimulation may help restore cytokine balance, which leads to a reduction in chronic inflammation. The vagus nerve is an important component of the neuroendocrine-immune axis that is involved in coordinated neural, behavioral, and endocrine responses that provide an important first-line innate defense against infection and inflammation and help restore homeostasis in the body.88 Diseases Inflammatory disorders in which tumor necrosis factor (TNFa) is a key cytokine are good candidates for treatment directed at the cholinergic anti-inflammatory (CAP) pathway.88 In essence, the inflammatory reflex is a physiological mechanism through which the vagus nerve regulates immune function and inhibits the production of inflammatory cytokines,87 thereby preventing excessive inflammation by alerting the brain to the presence of cytokines, which triggers the release of anti-inflammatory molecules that reduce inflammation and maintain a healthy balance.89 One of the potential important for vagus nerve stimulation is related to its role in the cancer prognosis. In a review article titled,The role of the vagus nerve in cancer prognosis: a comprehensive systematic review,the authors emphasize that cancer continues to be the second leading cause of death in the world, with prostate cancer being the most prevalent type of cancer in men and breast cancer in women. Cancer is a complex condition because it includes several hundred different types and because it involves and is affected by many systems in the body. Studies have shown that three basic biological factors contribute to the initiation and progression of tumorigenesis: (1) oxidative stress, which leads to DNA damage, (2) inflammation, which helps evade apoptosis, angiogenesis, and metastasis, and (3) excessive sympathetic activity, which affects where cancer cells will metastasize. A factor common to these three factors, which inhibits all three and influences cancer prognosis, is vagus nerve stimulation because it reduces oxidative stress, informs the brain about inflammation and profoundly inhibits inflammation and inhibits sympathetic activity, since which is an important branch of the parasympathetic nervous system.90 Another important aspect of vagus nerve stimulation, and one that concerns us all, is the speed with which we age. In a study titled,Effects of transcutaneous vagus nerve stimulation in subjects older than 55 years: potential benefits of daily stimulation, the authors point out that [the rate of] aging is associated with attenuated autonomic function. One segment of his study involved self-administered transcutaneous electrical stimulation of the vagus nerve (tVNS) to 20 women and 9 men once daily for two weeks. Measurements included heart rate, blood pressure, and respiration. Frequency-domain, time-domain, and nonlinear heart rate variability and baroreflex were obtained in the last five minutes of each recording. In addition, participants completed the SF-36 Profile of Mood States questionnaire at the beginning of each session. The authors reported improvements in participants' vagal tone and autonomic tone, noting that their study provides "new and timely data showing that daily tVNS may have profound autonomic benefits in older people.>55 years.” They concluded that “For the first time, we have shown that age-related autonomic changes, quality of life, mood, and sleep can be improved by daily administration of tVNS for two weeks.”91 Other interesting and potentially crucial aspect of vagus nerve activity concerns the link with heart rate variability (HRV), the variability of heart rate intervals between beats that is strongly correlated with vagus nerve activity and cardiac autonomic regulation .

HRV power spectral density is usually expressed in milliseconds squared (ms2), plotted against frequency (courtesy of EliteHRV.com)

The power spectral density (PSD) of high-frequency heart rate variability (HF-HRV is heart rate activity in the range 0.15 to 0.40 Hz) is strongly associated with cardiovagal activity. 92 (For comparison, low-frequency (LF) cardiac activity is in the range of 0.04 to 0.15 Hz.) The LF and HF frequency bands are widely used to quantify sympathetic and parasympathetic regulation.92 The vagus nerve plays an important homeostatic role, indicated by people with high HRV who have shown better rates of recovery from physiological stress on the cardiac, hormonal and immunological. systems, compared to those with lower HRV. In twelve studies investigating the association between vagal tone activity and prognosis prediction in cancer, including 1822 patients, the emerging evidence was consistent in demonstrating a prognostic role for vagal activity and a significant correlation between time to survival and high-frequency heart rate variability. . Using the HF-HRV vagus nerve index, when data from a cohort of women with metastatic and recurrent breast cancer were analyzed, it was found that in a sample of 87 women, a higher HF-HRV significantly predicted long-term survival. term. It was also found that the predictive validity of the HF-HRV was improved by dividing it by the patients' heart rate, thus reflecting a more vagal/sympathetic relationship. The review study authors urge serious consideration of adding HRV to clinical estimation of prognosis in oncology. improve vagal tone with many potential health benefits. The vagus nerve can also be stimulated by acupuncture, by experienced and licensed acupuncturists. Electrical vagus nerve stimulation (VNS) was first studied in the 1930s and 1940s with animals, setting the stage for human studies. After successful clinical trials, the FDA approved the use of an implanted electrical vagus nerve stimulator for the treatment of certain types of epilepsy in 1997. The procedure involves implanting electrodes near the vagus nerve in the neck, along with a controller and a battery implanted in the chest. The FDA later also approved the same mode of treatment for use in drug-resistant chronic depression.89

The transcutaneous (through the skin) vagus nerve (tVNS) is currently emerging as an alternative and aims to deliver electrical stimulation to the vagus nerve without the need for implant surgery, thus avoiding the associated risks. Stimulation is typically delivered via the auricular branch of the vagus nerve through the tragus of the auricle. The European Union certified tVNS as an alternative treatment for epilepsy and pain in 2010 and 2012, respectively.89

The pinna, showing the location of the tragus where the vagus nerve ends (Courtesy of Tori Lewis Fibonacci Web Studio)

As far back as 2001, researchers demonstrated that electrical stimulation of the vagus nerve through the tragus, using a form of electroacupuncture, reduced the dependence of patients with coronary artery disease on vasodilator drugs.93 In their study, titled,Vagal neurostimulation in patients with coronary artery disease, the authors stimulated the area of the ear near the ear canal containing the auricular nerve endings, through electrodes attached to short acupuncture needles, inserted to a depth of 0.1 to 0.3 mm. The authors concluded that electrical stimulation of the atrial nerve results in tonic activation of central vagus nerve structures and that increased vagal tone improves cardiac blood flow in patients with severe angina through dilation of spastic cardiac microvessels. .93 Pain referred to the ear from myocardial infarction has also been reported, due to the connectivity of the ear and the heart through the vagus nerve.94 In the study titled,Anti-inflammatory properties of the vagus nerve: potential therapeutic implications of vagus nerve stimulation,88 tVNS electrical frequencies used to activate vagal afferents to mediate depression and epilepsy are cited between 20 and 30 Hz and activation of the anti-inflammatory cholinergic (APC) pathway between 1 and 10 Hz. The authors mention the anti-inflammatory properties of the vagus nerve both through its afferent fibers ( HPA axis activation) and efferents (CAP activation) and that it is a good therapeutic target in inflammatory conditions of the digestive tract, for example, irritable bowel syndrome and rheumatoid arthritis.tVNS SonopunctureSeveral commercial manufacturers are now producing devices that provide transcutaneous electrical stimulation of the vagus nerve,95,96,97 and others that use infrasonic sound.98 Returning to the topic of sonopuncture and the Niels Bohr Institute research discussed earlier in this article, it has been demonstrated that the nerves conduct sound (soliton impulses), which in turn generate electrical pulses, due to the piezoelectric effect. points of the ears, it is clear that this can also be achieved sonically, and that such sound stimulation will automatically lead to electrical stimulation of the auricular branch of the vagus nerve, due to the piezoelectric effect. In this scenario, full earphones must be used, allowing the entire ear to receive the sound frequencies.

Frequencies too low for tvNS can be transmitted audibly through headphones

The very low frequencies commonly implemented in tVNS therapies can be created sonically through high-specification headphones, and several manufacturers now produce headphones that can output sounds as low as 5 Hz. 99,100,101 Although studies of this type have not been performed, this This form of sonipuncture may have great therapeutic potential to treat a wide variety of diseases, some of which have been mentioned in this section, including chronic inflammation. Sonic stimulation of the vagus nerve would be obtained by means of sinusoidal tones, generated by an audio signal generator and fed to the headphones through a suitable audio amplifier capable of handling very low frequencies. However, specially prepared music can also be used therapeutically, or rather, music with very low frequencies identified in tVNS studies can be added to music, incorporated into recording or added separately to the input of the amplifier powered by an electronic generator. signs. . In such a scenario, the patient would be able to take advantage of the many health benefits of listening to music markers, mentioned earlier in this article, while the vagus nerve would be vibratoryly stimulated by sonopuncture frequencies below the range of hearing, thus improving the health. benefits, for example, by reducing chronic inflammation. Before discussing vocal stimulation of the vagus nerve, we make special mention of the work of the French otolaryngologist Alfred A. Tomatis (b. 1920, d. 2001). Doctor Tomatis received his medical doctorate from the Paris School of Medicine and theorized that many vocal problems are actually hearing problems, based on the concept thatthe voice cannot produce what the ear cannot hear,known today as 'The Tomatis Effect'. Tomatis has developed the 'Electronic Ear', a device that uses bone conduction and sound filters to improve the tone of the muscles of the middle ear, to sensitize the listener to stray frequencies, particularly in the high registers. The ear begins to form a few days after conception and is fully developed by the fourth month of pregnancy. Tomatis theorized that information from the fetal ear stimulates and guides brain development. He believed that various auditory communication problems began in pregnancy, when the fetus did not respond adequately to the mother's voice. In children with ASD, he believed that his electronic hearing device simulated the sound of the mother's voice heard in utero, leading the child to gradually accept and respond to his real unfiltered voice. He reported that this method often produced surprising results, with children crying with joy when they recognized their mother's voice for the first time. He wrote: “It is this [vagus] nerve that helps the singer to consciously rediscover the correct respiratory rhythm, as well as heart and visceral rhythms, so that a synergy is created between this internal network and the larynx… of speech… Without a doubt , singing is one of the best ways to free ourselves from the burden of parasympathetic or neurological imbalances.”102

vocal stimulation of the vagus nerve

Finally, in this section of the article, the laryngeal connection to the vagus nerve expresses and directly influences internal visceral states through the voice. In the article,Chasing the quiet hum: how polyvagal theory links stage presence, mammalian evolution, and the vocal nerve root,103 Joanna Cazden discute Stephen W. Porges 'polyvagal theory' that emphasizes phonation, breathing and hearing. Porge's research proposes that the voice is strongly influenced by the neuroregulation that underlies our ability to communicate, and since the vagus nerve mediates our emotional state and laryngeal muscle activity, our visceral states directly influence and are expressed through voice. voice. of the autonomic vagus nerve, its influence on behavior, and its implications for vocal interpretation, requires a distinction between the neurophysiological aspects of the two major subbranches of the autonomic system, the sympathetic and the parasympathetic.103 These two aspects of the autonomic nervous system can be consider the system to be both a sympathetic and a downstream parasympathetic accelerator, providing bidirectional neural communication between our organs and the brainstem.104 Various neural pathways in the brain can send sympathetic signals to stimulate a faster heartbeat, butonly the vagus nerve sends a slowdown signal, achieved during exhalation: the heart beats a little faster we inhale and more slowly when we exhale.105 This effect is called respiratory sinus arrhythmia (RSA), which is a measure of vagal tone. The auditory nerve (CN VIII) that carries sound signals from the ears to the brain receives interference from the myelinated vagus nerve. Porge mentions that the voice is a powerful trigger for the physiological states of others and that emotional prosody is an audible signal of the autonomic state, recognized in the listener's brain. Because the laryngeal nerves branch directly from the vagus, the voice conveys our internal resilience and expressive visceral state to others through sound.103

In the study,Song structure determines singers' heart rate variability,106 suggests that singing can be seen as starting the work of a vagal pump: singing produces slow, regular, deep breathing which, in turn, triggers RSA, causing pulsatile vagal activity. Also, as discussed in the sectionActive and passive sonic stimulation of the nostrils and lungs,singing, singing and humming stimulates nitric oxide production in the nasal cavities and lungs, with many associated health benefits. Playwright John Guare said, "The purpose of art is to exercise the muscles of the soul, so that when life's challenges come, we are ready." Porge's polyvagal theory suggests that these "soul muscles" can be found in the small area of ​​the brainstem where a single myelinated pathway influences the remarkable vagus nerve.103

Vibrational Medicine: The Future

The fictionalized depiction of a therapy bed from the future in the television series 'Star Trek' has inspired the imagination of millions of viewers of what might be possible in the 22nd century. However, even now, 21st century medical physics is beginning to develop a non-invasive diagnostic bed capable of indicating asthma, sepsis, and even various types of cancer by monitoring the gases and compounds exhaled by patients. The technology that makes this possible is a mass spectrometer, the same type of instrument aboard NASA's Perseverance rover on Mars, which looks for signs of life. Other instruments that could be integrated into this future bed includethermographic and hyperspectral cameraswhich will track temperature and skin color to monitor a patient's metabolism, while ultrasound sensors will non-invasively measureblood flow and oxygenationto analyze heart activity and blood circulation in real time.107 Brain activity can now also be measured without connecting electrodes to a patient's scalp, using a superconducting magnetometer quantum interference device (SQUID), making it possible to monitor the neurological conditions remotely. The distance between the skull and the magnetometer is normally 2 cm at present, but future improvements in sensitivity may make it possible to build the magnetometer on the bed frame, providing EEG readings at the head of the bed. These powerful diagnostic aids sound like science fiction, but they are becoming reality. Also mirroring Star Trek, active healing technology could be incorporated into hospital beds of the future. For example, as this article highlights, the mediation of chronic pain without the use of analgesics is already possible through sound vibrations applied to specific parts of the body, which can be done with the patient in the supine position. Several manufacturers have developed commercial vibroacoustic beds 108,109,110 and their use in clinical settings is likely to play an increasingly important role in hospitals of the future. oxygen levels, as the author's preliminary studies have shown, thus supporting the cure of many diseases. Sonic stimulation of a patient's lungs and nasal cavities would also increase their nitric oxide levels, thereby stimulating vasodilation, lowering blood pressure, and providing many other health benefits. levels, providing a helpful boost to your immune system, crucial for healing processes. One of the biggest challenges for medicine in the 21st century is the eradication of cancer, but a discovery made by UCLA Professor James Gimzewski in 2002 offers intriguing potential to eradicate not only cancer cells, but any pathogens as well. Using an atomic force microscope, he and his colleague Dr. Andrew Pelling and his team were able to hear the sounds of the cells for the first time. Surprisingly, they found that cell breath sounds fall within the audible range when amplified, calling their new approach to cell biology 'sonocytology', referring to the 'songs' of cells.111,112 Raman spectroscopy offers an alternative method affordable to record the songs. of cancer cells, which differ significantly from healthy cells. In a study conducted by the author, in collaboration with Professor Sungchul Ji, from Rutgers University, sounds from cancer cells and healthy cells, derived from Raman spectroscopy, were made visible with the aid of a kimascope instrument, imprinting sound vibrations into the medical-grade water, like a fingerprint on glass, thus leaving a visual signature of cellular sounds. A typical cymaglyph (sound image) of a healthy cell is symmetrical, while that of a cancer cell is distorted by comparison. The study, titledImages and sounds of healthy cancer cells in water by cymscope followed by quantitative analysis by Planck-Shannon classifierwas published in the Water Journal (waterjournal.org), since the revealing medium for sonic vibrations in the kimascope instrument is water.113

Cymaglyph of healthy cells (left), Cymaglyph of cancer cells (right)

This collaborative study was a first step toward creating visual images for a surgeon who would wear specially designed glasses to see, in real time, changing sound patterns as the Raman laser probe is scanned into tissue during a surgical procedure. However, the most exciting aspect of this new technology lies in its potential to detect cancer early and ultimately destroy cancer cells. By taking a biopsy of a cancer, its sonic signature can be detected and amplified and then used to modulate an ultrasound beam aimed at a tumor. In this scenario, the tumor cells would absorb enough acoustic energy (from the cancer cell's own sonic signature) to be destroyed. Such a therapeutic procedure would likely be administered during a series of outpatient visits, in which a percentage of the tumor mass would undergo controlled reduction at each visit, to minimize toxic waste of material from dead cancer cells. For leukemia patients, this principle has the potential of sonic irradiation of the patient's blood through a specially adapted intraoperative recirculation system. environmental changes, eg glucose depletion, heat shock, free radicals, pathogen invasion or toxicity. When a cellular system is in the G0 phase, it creates an imbalance in the body, resulting in physiological symptoms, but hypothetically, cells in this "asleep" state can be stimulated back into the normal cell cycle by immersion in frequencies of specific sound or in song (Remember that research 111,112 by Professor James Gimzewski indicated that the sounds made by cells are in audible frequency ranges, typically centered around 1 kHz). The almost holographic nature of sound and the spherical spatial shape of audible sounds, mentioned in the introduction to this article This is why Faraday wave patterns manifest in the surface membranes of cells, organs, the visceral fascia and visceral fluids. Although it is beyond the scope of this article, this is also why all energetic information within a specific sound frequency, or within music, is transmitted to the cell. Also popularly known as 'cymatic patterns' after Dr. Hans Jenny, who coined the term to mean 'visible sound', the importance of this natural phenomenon is vital to the future of vibrational medicine. Integral membrane proteins and the cells' primary cilia are, in a very real sense, massaged by the anti-nodal pressure points of these microscopic sound patterns, stimulating cells in ways yet to be discovered. Sound organizes matter, a fact that can be seen in simple experiments on the Chladni Plate with particulate matter and in more sophisticated experiments with the CymaScope instrument, in which liquid water is used as the printing medium to translate sonic periodicities into periodicities. of water waves. .7 Life as we know it cannot exist without liquid water; Professor Gerald H. Pollack extensively discusses 'structured water', or 'exclusion zone' (EZ) water, in his groundbreaking book,The Fourth Phase of Water.114 Proposes that EZ water (H3O2) literally generates the electricity that helps power all living creatures. Here's a connection waiting to be explored between the sound frequencies that organize water molecules and the EZ water that fuels life. Professor Pollack discovered that EZ water is built by light, particularly infrared light, leading to a potentially fascinating connection between sound and our physiology:inelastic sonic collisions create sonically modulated infrared light that powers the EZ water building mechanism in cells, which in turn powers our biology.The organizational aspect of the sound and its EZ water build mechanism is it is already beginning to provide insight into what might be called "sleep biology", a field in which the role of structured water and sound is likely to be increasingly important in medicine.

These are just a few of the many advances in medical science that have the potential to help humanity in its quest to reverse disease, prolong life, and improve quality of life. Sound's role in medical modalities is growing every year for drug-free therapies and diagnostic applications, and it is finding welcome support among many physicians and hospitals around the world. I predict that sound therapy and music medicine will play an important role in the future of medicine, which deserves to be developed and nurtured.

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