What Hippocrates was to the Allopath, what Hahnemann was to the
Homeopath, Andrew Taylor Still is to the Osteopath, and it is safe to
say that when another century shall have rolled away, his fame will be
equal to that of either. That he is a maker of history, even the most
skeptical will admit. His teachings are revolutionary but are borne out
in fact, and on that as a foundation, is built the superstructure of
the young therapeutic giant—Osteopathy.
It would be of great interest to trace the history of the first
inception of the thought that drugs were not only unnecessary but
harmful, then view the struggle to grasp something tangible to take
their place, then see the development of the idea that the human body
has within it all that is needed for its upbuilding and repair until he
came to this fundamental: “The power of the artery must be absolute,
universal and unobstructed or disease will result. The moment of its
disturbance means the period when disease begins to sow the seeds of
destruction in the human body; and in no case can it be done without
a broken or suspended current of arterial blood,” capped by the
epoch-making discovery of the cause for this interrupted flow of the
blood stream—the theory of obstruction by anatomical displacement. It
is the only theory of the etiology of disease that will stand the test
of science and its acceptance and practice means a revolution in the
field of therapeutics.
As it is, he sets the exact date, June 22, 1874, when the light dawned
and he saw the outline of his great philosophy—Osteopathy. Then came
the years of adversity and struggle. With the eye of a prophet he saw
the future of that philosophy, and with the firmness of a Spartan
has defended it since birth. It must be a separate, distinct system.
Outside the fact that it was to heal the sick and was founded on a
knowledge of anatomy and physiology it had nothing in common with
existing schools, and if it were ever to grow it must be alone, for
his brother practitioners would have none of it and if left to their
tender mercies it would have “died a-borning.” Even had it been taken
up the result would have been the same for they would never have fully
developed it. And so through the lean, terrible years he struggled,
buoyed by the faith of a discoverer, urged on by love of this child of
his brain, fanatical in his determination to win. And win he did for it
was vouchsafed to him in his vigorous old age to sit on his hearthstone
and see the results of his work, his struggle and his faith. It is
something to know that his fame has circled the earth, to be honored
and sung by millions; a boon not accorded many a sage or philosopher.
Not only has the public accepted it but the medical profession is
making tardy but forced recognition of certain cardinal principles of
osteopathy by using them, but, of course, without credit.
Osteopathy has been defined as “that science or system of healing
which emphasizes, (a) the diagnosis of disease by physical methods
with the view of discovering, not the symptoms but the cause of
disease in connection with misplacements of tissue, obstruction of
the fluids and interference with the forces of the organism; (b)
the treatment of disease by scientific manipulations in connection
with which the operating physician mechanically uses and applies the
inherent resources of the organism to overcome disease and establish
health, either by removing or correcting mechanical disorders and thus
permitting nature to recuperate the diseased parts, or by producing and
establishing antitoxic and antiseptic conditions to counteract toxic
and septic conditions of the organism or its parts; (c) the application
of mechanical and operative surgery in setting fractures or dislocated
bones, repairing lacerations and removing abnormal tissue growths or
tissue elements when these become dangerous to organic life.”[1] In
a word, osteopathy is adjustment and the osteopath is an anatomical
engineer who knows what is wrong and has the ability to correct it.
Dr. Still changed diagnosis from guess work to fact and on it his fame
may well stand, for when the cause of the disease was found, treatment
was easy. He has ever emphasized the necessity of thorough examination
and correct diagnosis. All treatment must be based on the definite,
specific object to accomplish certain definite, specific things.
“Osteopathy would expound and apply the true philosophy of
manipulation. While the hands are used, it is not this alone and
chiefly that distinguishes its method of operation, but the idea and
purpose that lie behind manipulation.”[2]
All manipulators are not osteopaths any more than all butchers are
surgeons. The need for deep study of the subject is apparent from this
characteristic statement of Dr. Still’s: “Osteopathy is a science; not
what we know of it, but the subject we are working is deep as eternity.
We know but little of it. I have worked and worried here in Kirksville
for twenty-two long years, and I intend to study for twenty-three
thousand years yet.”[3] This brings us to the point of the relations of
osteopathy with other manipulative forms of treatment. They are not
many, for Gerdine,[4] in closing a long article on the “Physiological
Effects of Mechanical Therapeutics” says: “I have striven to show that
in no way is Osteopathy similar to massage either in theory or practice
if Osteopathy is conceived of, according to its founder, Dr. A. T.
Still, as a system of healing in which a definite lesion in form of a
bony displacement is the causative factor and a removal of the same,
the curative factor in disease.”
The fact that use is made of the hands to the extent it is by both
osteopaths and masseurs or Swedish movement operators gives rise to the
mistaken idea of similarity in treatment.
“The essential distinction,” says G. D. Hulett, “between Osteopathy and
all other systems of healing based on manipulation, clusters around
the etiology of disease. While these other systems, as indicated at
least by their practice, look at disease from a peripheral standpoint,
osteopathy views it from a central standpoint.”[5]
Massage is a small branch of manipulative therapeutics, but conceding
that it is perfect and scientific it can only resemble osteopathic
treatment in one ramification of osteopathic practice, viz: relaxation
of muscles.
The fact that massage is often employed by osteopaths in connection
with their work shows the limitations of that form of treatment. Says
McConnell[6]: “In the human body, as in any delicate, complicated
mechanism, there is mechanism within mechanism; and, in order to
obtain certain mechanical effects, many times there is required a
series of complicated movements, all of which bear a ratio one to the
other according to the energy utilized and the mechanical principle
involved.” No other form of manual treatment takes this principle of
mechanics into consideration. It is possible, as Gerdine points out,
for an undeveloped osteopath to practice massage under another name.
That the two should be confounded before the public is due to his
ignorance and not from any fault of the system. Massage is a valuable
aid in the treatment of disease but it is not Osteopathy.
“In the bright lexicon of osteopathy there is no such word as rub[7].”
Osteopathy in its relation with medicine has little in common.
From the beginning, its founder realized their paths should run
divergently, so the first step, its teaching, must be considered from
a different viewpoint. To quote from an address by Teall[8]: “But
to adequately teach osteopathy a vast amount of original work must
be done. Anatomy is anatomy but there is a vast difference in its
application. Physiology must be taught to mean something more than an
interesting phenomenon. Pathology has an unfilled gap between cause
and effect which must be bridged. The post-mortem has a great story
to tell but an osteopath must tell it. A slide of degenerated tissue
under the microscope is of interest, but why the degeneration? It is
described at length by the authorities, but the reason for the causes
and morbific changes are not carried out. Obstetrics along strictly
natural and physiological lines insuring both mother and babe against
injury; gynecology, minus the knife and plus common sense; all these,
and more must be put into shape to teach the osteopathic student. The
archives of osteopathy were empty ten years ago. There was no precedent
to follow and the ideas in teaching which had prevailed for centuries
dominated. All this is changed. The colleges teach the science along
strictly osteopathic lines, making the application of the truths which
have escaped the notice of centuries of investigation.”
All schools recognize the wonderful recuperative power of nature, as
this from the introduction of a standard allopathic text book will
show[9]: “There is no scientific dogma better established than this:
that the living organism is in itself adequate to the cure of all its
curable disorders. This natural law sustains the medical skeptic in
his infidelity, enables the homeopath to report his sugar cures, and
helps all physicians out of more close places than they are generally
willing to acknowledge.” But at times, as all will agree, nature is not
able to overcome its maladies and assistance is needed. Here, again, is
a divergence as to the method and character of that assistance. There
is no system so trivial or absurd which cannot point to its cures, but
a school of medicine should have a settled system with established
methods of procedure. This is not true of any school employing drugs as
its principal therapy. In the President’s annual address at Cleveland
he says[10]: “The observant reader of the progressive medical press
is struck at once by the unsettled condition in the field of modern
therapeutics. The trend is emphatically away from drugs. But, in
the effort to get away from medicine, the medical investigator has
wandered far afield, cutting loose from nature and resorting to the
artificial.” It is the last paragraph of the extract quoted which
particularly emphasizes the point of divergence, natural _versus_
unnatural methods. It must be understood at once that the osteopath
admits the reality of drug action for “there is no doubt that the
pharmacopeia records many drugs whose action is rapid and effective so
far as securing activity or decrease of secretion is concerned, but the
element of danger, i. e., their destructive power is great. Oftentimes
their power does not stop at the point desired or limit its effect
to the therapeutic action sought[11].” This point of unreliability
of the drug is emphasized by the following from recognized medical
authority[12]: “We give drugs for two purposes: (1) To restore health
directly by removing the sum of the conditions which constitute
disease. Here we act empirically with no definite knowledge—often
indeed with little idea of the action of our drugs, but on the ground
that in our hands or in the hands of others they have restored health
in like cases. (2) To influence one or more of the several tissues
and organs which are in an abnormal state so as to restore them to or
toward the normal; with the hope that if we succeed in our purpose
recovery will take place. The purpose we effect by means of the
influence which the chemical properties or drugs exert on the structure
and function of the several tissues and organs. Minute information,
therefore, of the nature of drugs and their action is essential for
their proper employment.” Osteopathy brings into action the latent
or stagnant forces of nature by specific methods which are usually
reliable. Naturally there being such a wide difference in theory of
the cause of disease it would be also shown in diagnosis as well as
treatment. The most striking points to the layman in medical procedure
are: first, wide difference in the system of diagnosis and in its
findings by physicians of the same school; second, the great variance
in remedies employed by different physicians of the same school for the
same disease.
Osteopathic diagnosis is so physical in its character, depending upon
actual conditions found and not upon the subjective symptoms alone,
that the same patient examined by a number of experienced osteopaths
will be given the same diagnosis, and he will also be able to detect
in each the same effort to correct in all their technique. All the
methods of physical diagnosis are used plus the distinctive osteopathic
procedure. Results wherever used bear out the effectiveness of the
system.
The osteopath must and does consider the necessity of surgery, but
his effort is always to prevent the operation if possible. There can
be no doubt that surgery is carried to extremes and there is a strong
sentiment growing that much of it is unnecessary. Says Homer Wakefield,
M. D.[13]: “It is to the everlasting disgrace and mortification of
the medical man that the wealthy classes who are continually under
the observation and direction of eminent men, in dietary, and all
life habits, in health as well as in sickness, are not only the very
ones who develop appendicitis and most largely go to operation, but
are almost exclusively those who attain to this distinction.” The
operations of today are wonderful and the surgeon shows great skill and
genius in their performance, but great as he is in these matters how
infinitely greater is the man who can prevent them. The need of the
osteopath today is to be trained to recognize surgical conditions and
neither allow surgery unnecessarily nor make the more terrible error of
not acting soon enough. Where surgery is a necessity there is always
an etiological factor to be considered. The cause of the manifestation
not always being removed what is to prevent a recurrence or serious
sequela in spite of the operation? “The specialist ... if he has wit
enough to read the lesson presented to him, that it is not sufficient
to remove an ovarian tumor, e. g., and that if nothing is said at the
same time or subsequently as to the causes which induced it, a positive
damage may be done to the woman, who may, therefore, while considering
herself cured, proceed to manufacture one on the other side, or may
find herself in a few years suffering from cancer in the stump of the
previous one[14].” And so the combination of osteopathy with surgery
may be necessary that the cause shall be removed. Osteopathic treatment
before operations in reducing congestions and inflammations, also in
toning the nervous system, is particularly efficacious while the after
treatment gives gratifying results. In fact, the two go hand in hand
when conservatism rules both.
That diet should receive particular attention from the osteopath is not
strange, for his veneration of nature peculiarly fits him to realize
the necessity of correct feeding. Probably no subject is more discussed
or presents a wider range of opinion than diet. There is overfeeding
and underfeeding; long intervals and short between feedings. There is
the no breakfast and no supper plan, mixed diet and the vegetarian,
uncooked foods, and one exclusively of milk, anything you want so long
as you are hungry but chew it well, etc., ad. lib. All are represented
by osteopaths in their following as they are from other professions,
but probably this would more nearly represent the views of them as
a school. In health, first, most people eat too much and do not
thoroughly masticate and insalivate. This applies to all stations of
society. Second, meat forms too large an item in the daily dietary.
Third, there is not enough variety and the ration is not well balanced
as to elements. Fourth, not enough care is used in preparation of
foods. In illness, first, the stopping, complete or partial, of food
until the system can take care of it; second, the giving of easily
digested foods. The man who avoids violent extremes in diet as well
as in other habits of life will usually last longest. It is to be
hoped that some rational system can be evolved on which all factions
may agree, for the present confusion of authorities is bewildering.
The osteopath gives attention to hygiene, sanitation, exercise,
environment, mental attitude, etc., as they may affect the welfare of
his patient.
Osteopathy can cure all curable diseases, for the same forces which
will overcome one malady will overcome another when set in motion.
Forces that produce a diseased condition will it normalized restore the
established type.