Dr. A. T. Still Founder of Osteopathy
M. A. Lane
1918
CHAPTER II
A. T. STILL SCIENTIST AND REFORMER
The key to the work of Andrew Taylor Still in his capacity as a scientific reformer
was his unusually and powerfully original mind. Like all men of surpassing genius
his one great dominant characteristic was his strong and active originality. He
was by nature entirely unfitted to follow in beaten paths those who had gone before
him. To strike out in new directions, to carve for himself with his own hammer
and chisel the block of knowledge, theory and practice, was for him a necessity;
and few of the many theories he held were borrowed from or suggested by his predecessors
in the art of medicine. He appeared on the stage of medicine when that art was
just on the verge of the searching and universal scientific reforms that were
destined soon to change the entire point of view with which men, up to that time,
had been accustomed to regard their own bodies in health and disease. But in his
earlier days established medical practice was almost as barbaric and ancient as
it had ever been since the age of the great Greek school of physicians in the
time of Pericles, five hundred years before Christ.
When Dr. Still was a young man, speculating on the cause of cholera, many of
the great scientific discoveries and epoch-making inventions in the art of medicine
were just in the making, or were being one by one announced to an astonished
and unbelieving world. That was the day when Europe was yet ringing with the
freshly announced discoveries of Theodor Schwann, who was the first to see and
announce the fact that the bodies of all animals were built up of cells - the
so-called "Cell Theory" of Schwann, a theory which, like Ehrlich's theory of
immunity, soon passed into the realm of undisputed fact. That was the day when
the new pathology - the cellular pathology-was germinating in the mind of the
great Virchow, who has been rightly called "the father of pathology"; when the
powerful Louis Pasteur was doing his best thinking in the remarkable controversies
concerning life and its origin that were then raging in Europe, with Liebig
on the one side and Pasteur on the other; when Helmholtz was forging in his
mathematical workshop the law of the conservation of energy, and reducing to
demonstrable fact the conception that living bodies were chemical and physical
machines in which energy was transformed but never lost; when Johannes Mueller,
the father of modern physiology, at the very apex of his career, was about to
pass away; when the term "irritability of living matter" was refreshingly and
startlingly new; when the chemists of Germany and France were discovering the
marvelous facts of organic compounds, and searching by synthesis and analysis
into the secrets of living nature; when the theory of "vital force" was rapidly
disappearing out of the minds of scientific thinkers; when Darwin was forging
the links of his great chain of natural selection; when von Baer was first perceiving
the amazing facts and their laws of the new-born science of embryology; when
Haeckel was observing (for the first time) the fact that the white cells of
the blood had the power of ingesting small particles of dead matter-the first
perception of the "phagocytosis" of Metchnikoff ; when Claude Bernard, the French
physiologist, was announcing his theory that all substances that could enter
the body were to be regarded as either foods or poisons; when pepsin was being
discovered by Schwann, and the structure of the kidney by Henle; when, in one
word, the whole scientific world was in a state of ferment, in which wholly
new views and facts about living matter were being upturned and established
every day, and the old foundations on which medicine had been resting for ages
were being rapidly and surely dissolved away. It was in such an age that A.
T. Still appeared.
ANTICIPATED THE BEST SCIENTIFIC THINKING OF EUROPE
When Dr. Still was beginning to see clearly through his newly formed ideas
of therapy and the causes of diseases in general, the science of modern pathology
was in its infancy, and the science of bacteriology, as we know it today, was
as yet virtually undreamed of ; the science of physiology was only just beginning
to show its first and broadest outlines; and the sciences of histology and embryology
were only beginning to be understood in their more startling details; and we
can say with absolute truth that Dr. Still was the only man in America who could
in any way whatever be regarded as being abreast with the spirit of Europe;
rather let us say he was, in many of his primary conceptions, forty years ahead
of Europe and his age, a fact which we will try to show here, and a fact which
will be amply recognized in the history of medicine as it will be written in
the time to come.
To appreciate Dr. Still's true inherent greatness, it is necessary to roll back
the years, to reverse history, and to realize to ourselves the medical doctor
of that early day, especially in the United States. Dr. Still's earlier life
say until he was 50 years old - was lived in a time when medicine in America
had cut itself entirely adrift from the medical education of Europe. In the
earlier years of the nineteenth century the American physician was always educated
in Europe, and in those primitive times, reaching back into the later years
of the eighteenth century, some of the most famous anatomists of Europe paid
now and then visits to these shores. In Philadelphia there still stands, or
stood until recently, an anatomical theatre, where anatomists exhibited and
lectured to the lay public on handsome dissections of the human body, as had
been the custom in Europe. Those were the times when no medical schools existed
in America, and all American physicians were educated abroad. With the rise
of the first medical colleges in America, however, this custom ceased, and toward
the middle of the last century, America was educating her own doctors, who,
in the beginning, were almost as well informed as their European colleagues.
But this equality of education soon passed away, and from then onwards medical
education in America was distinctly inferior to that of Europe. The American
medical colleges passed into the hands of American doctors who had themselves
never studied in Europe, and the result was that hundreds of medical schools
of inferior type sprang up in this country, and American medicine was now upon
an American basis, and a basis much lower, of course, than that of the great
universities of Europe, where the newer medical sciences were being born and
developed. Hence there was in America scarcely a handful of physicians of a
high scientific type. There were no discoveries made in America, and such medicine
as was here was of the distinctly old style, crude and backward, and loaded
with many of the superstitious beliefs and practices that had marked the medicine
of Europe before the days of Schwann and Pasteur, of von Baer and Raymond, of
Virchow and Helmholtz, of Bowman and Henle, of Mueller and Bernard and of the
other pure scientists whose work did so much to place medicine on a pedestal
higher than that of mere experience or empiricism. American doctors were notably
behind the procession of Europe, and only here and there could be found a doctor
with any appreciation at all of the medical reforms that were going forward
so rapidly in the universities on the other side of the sea. To this rule, surgery
was something of an exception. American surgery was always good, but surgery
is a thing distinctly apart from medicine, and in so far as the doctor was a
surgeon he was not a physician at all.
Such was the state of medicine in America when Dr. Still appeared, with entirely
new conceptions and theories concerning diseases, their causes and cures. In
the west of the United States, far remote from the slightest influence of Europe,
in the midst of the black ignorance and incompetence of American uneducated
doctors, grew up this singular reformer, who, had he risen in Europe, would
have exerted the most powerful world-wide influence from the very first.
HIS TWO GREAT DISCOVERIES, LESIONS AND IMMUNITY
Like all great original thinkers, Dr. Still had theories for almost every disease
and function of the body, and many of these theories were crude and incompetent,
just because the then state of the sciences he dealt with was still crude and
incompetent. In fact, when Dr. Still worked out many of his theories of disease,
the real causes of these diseases were wholly unknown and seemingly incomprehensible.
But of the various theories which, like sparks from a grinding wheel, flew off
from his original and ever-active mind, at least two were of prime order and
absolutely true and good. These were first, his theory of the mechanical (anatomical)
lesion, and secondly, his theory of the chemical immunity of the body, both
of which he put forth as the cause of disease, and both of which have absolutely
stood the test of time and subsequent scientific criticism and experiment. The
scientific historian of the future, who will write at a time when all prejudices
of professional jealousy and hate will have been lost in the great historical
perspective, will probably regard Dr. Still's greatest contribution to science
as being his theory of immunity rather than his wonderful perception of the
mechanical origin of so-called disease. For it is a fact that while the great
conception of the osteopathic lesion was directly responsible for the grand
dramatic debut of osteopathy and its seemingly miraculous cures, more recent
knowledge and understanding of osteopathic treatment and its results have called
attention in a striking and startling way to Dr. Still's other grand and primary
conception of the body's natural immunity; a conception primary in every sense
of that word; for it is upon this great fact of nature that the osteopathic
lesion, with all it means to the osteopath and the diseases he works in, hangs.
Dr. Still in his own mind and his own writings placed this great natural immunity
of the body first in order, and then followed it up with the correction of the
lesion, by which procedure the defensive and hence curative mechanism of the
body was given free play.
WAS FIRST TO ANNOUNCE THE THEORY OF IMMUNITY
In justice to the original mind of this American genius, it should be said
that Dr. Still was the first man to perceive the truth that nature has developed
in the animal body its own defenses against diseases. And with this thought
in mind we can for the first time see the power and real meaning in his well
worn axiom, "Find it, fix it, and leave it alone!"
The three last words contain the heart of the axiom - leave it alone; because
by leaving it alone, Dr. Still most certainly did not mean that the practitioner
should never touch his patient again! What he did mean was that after the lesion
has been corrected nature itself will do all the necessary subsequent work -
that is, it is not necessary (nay, it is hurtful) to thrust into the body the
drugs that, in his day, were believed by all doctors of all schools to have
some effect against the disease at work in the body. "Leave it alone" is nothing
but a vigorous protest against drug treatment which in Dr. Still's time was
the only treatment for any and all diseases which the surgeons' knife could
not remove.
OSTEOPATHY AVAILABLE IN THE INFECTIOUS DISEASES
While it is perfectly true, and rightly so, that the osteopath in the past
has seemed to rest his entire dependence upon the anatomical lesion (because
it was in the correction of these lesions that osteopathy in the beginning worked
its most amazing results), it is none the less true that by persistent effort
the osteopath has swept under his control diseases which the earlier osteopaths
were disposed to neglect as being, in some way or other, outside the domain
of the anatomical lesion. Today in the great center and mother institution of
osteopathy at Kirksville, a city made world renowned by Dr. Still and the system
of therapy he founded, there are young osteopaths, yet in the student stage
of their career, who, with entire confidence in their own power and the science
under it, treat all kinds of infectious diseases with a courage, or rather with
an entire want of fear, that reminds one of the primitive Christians.
EUROPEAN RESEARCH HAS CONFIRMED STILL'S TEACHINGS
All these facts are individual little monuments to the genius of A. T. Still,
because they show how well he anticipated the discoveries of the world's most
enlightened and capable scientists of later years; and if Europe, with the genius
of its laboratories, has given to the world a better understanding of the causes,
the prevention, and the rational theory of the cure of diseases, what it has
done is only the scientific demonstration of the theory of disease (the natural
defenses of the body) which was first perceived and announced as his own theory
of disease forty years ago by Andrew Taylor Still. Therefore, we say it is only
just to the genius of the man to give to him the credit for having been the
first to conceive this theory of immunity to disease, which, during the past
twenty-five years, has grown with such rapidity and strength as to fill the
whole world with its noise and to change radically all views of diseases and
the possibility of their cure.
An extraordinarily high degree of credit should be given him for this remarkable
and original perception for the very reason that it came to him at a time when
the facts of immunity were not at all understood, nor in any way seen or believed
to be concerned with disease in general. At that time, as well as in all previous
times, the bare fact of immunity, natural and acquired, was and had been for
ages familiar to men. It was a matter of common knowledge and experience that
certain diseases in men were followed by immunity to these certain special diseases.
It was a fact of common knowledge and experience, for example, that an attack
of smallpox was followed by immunity to smallpox in the future; that men perhaps
never had a second attack of the disease; that persons having passed through
one attack of the disease were universally regarded as being safe against a
second attack. Scarlet fever, mumps, yellow fever, measles, and other diseases,
called infectious or contagious, were similar to smallpox in their power of
conferring immunity against the disease. But this power of conferring immunity
was thought to be limited to those diseases alone in which the immunity conferred
was lasting throughout the life of the individual. Other diseases, to a second
or third or several attacks of which the body was susceptible, were not classified
as diseases that immunized the individual. But it is now known that all infectious
diseases do produce an immunity, in all ways similar to that produced by smallpox
except for the length of time during which the immunity lasts.
If, let us say, pneumonia produces an immunity which safeguards the individual
as efficiently as smallpox does, only that the immunity wears out, say in a
year or more, you have a similar power to that in smallpox, only the effects
do not last a life time. The same is true of typhoid fever, and in deed of all
infectious diseases. This will be seen to be necessarily true when it is remembered
that if an immunity, more or less lasting, were not produced by the disease,
the disease would never disappear, the patient never "get well". So that it
would appear that all infections act in the body in a way similar to smallpox
but with certain variations in the length of time during which the reaction,
or the "safety", lasts. This would bring all infection under the same natural
law; but the proof of these facts means only one thing, and that is this, that
an individual, not immune to a disease in the first place, but who becomes immune
after the disease has been acquired and "runs its course" with recovery, must
have in his body previously to the attack some kind of mechanism which the presence
of the disease excites to the formation of substances which now are in sufficient
quantity to prevent, for a longer or shorter time, a second attack of the disease.
This in turn must mean only that the body is equipped by nature with its own
cure for disease and with the power of preventing further attacks of the same
disease-for a longer or shorter time after the first attack.
THE BLOOD CARRIES THE BODY'S HEALING
Dr. Still urged virtually this view of disease, and held that the curative
and protecting thing was to be found in the blood and hence in the tissues,
and in this theory, simple as it appears today to us who are familiar with the
researches of Europe during the past twenty-five years, is to be found the very
first perception of the great law of immunity to disease of almost every kind,
including even the tumors. Dr. Still, in effect, urged the theory that all diseases
could be scientifically classified with smallpox, and similar immunizing diseases,
and that hence all diseases in their cause and cure could be referred back to
the blood. His axiom now follows: Remove the cause which stops or clogs the
blood flow, or which blocks the nerve which controls the blood flow, and the
blood itself will work the cure. "The rule of the artery is supreme."
HIS IMMUNITY GENERALIZATION REQUIRED YEARS TO BE UNDERSTOOD
Now when Dr. Still began to treat diseases on this principle the entire principle
itself was not only amazing to the then current ideas of disease, but was also
incomprehensible even to the best thought of his time. To bring virtually all
diseases under one main principle was, to the science of that day, a complete
absurdity. To say that smallpox, tuberculosis, pneumonia, whooping cough, pimples
on the face, leprosy, syphilis, typhoid fever, diarrhoea, a "cold" in the head
and cancer were one and all referable to the same basic law (the state of the
blood) and perhaps curable by the same method, were the whole problem in all
its phases mastered, was not only "revolutionary" but was a wildly impossible
and clearly absurd theory of disease in its causes and its cure. But let us
ask, in the light of the scientific progress of the past quarter of a century
just how absurd and impossible it really was?
Since that time the clear sun of science has risen higher and higher every
day to dissipate the darkness that shrouded disease up to the day of Still and
his discovery. Rather say, sun after sun of science has risen in succession
to that first illuminating discovery of Dr. Still. Metchnikoff rose to show
how the white cells of the blood ingest disease germs, ridding the body of these
destructive agents, and indeed normally preventing the onset of infections;
Buchner, the German bacteriologist, rose, showing how ferments could be separated
from the organisms that made them; Uhlenhut rose, to show through his pupil
Nuttall, how disease germs, multiplying in the animal body, produced in the
blood of the animal a substance that could kill the germs that produced it;
Pfeiffer, another German, rose to show how the serum of an animal inocculated
with typhoid or cholera germs would dissolve typhoid or cholera germs, but no
other; Behring, the pupil of the great Koch, rose to show how the poisons of
bacteria could produce in the body of the animal into which they were injected
a counter substance which could neutralize and render harmless the toxins themselves,
calling them anti-toxins; Bordet, the Frenchman, rose to show how these laws
applied to the blood cells of other animals when injected into an experimental
animal; Ehrlich rose, to show why all these things had to be true and how the
mechanism of the body did its work in the cure and prevention of disease; and
finally Abderhalden, the youngest of this array of scientists, rose to show
how the tumors were to be classified in their general laws with the disease
germs, so called, the bacteria of the bacteriologists. Limb after limb of the
great problem has been brought under control and more or less understood, and
today not to subscribe in full to the principle first laid down by Andrew Taylor
Still forty years ago, is to confess one's self as having no knowledge or understanding
at all of the progress made by biological science within the past twenty-five
years, or (we can say to the uninformed critics of osteopathy) to confess one's
self a person with no knowledge or understanding of Andrew Taylor Still and
his theory.
With these facts in mind we can see A. T. Still as the original discoverer
of one of the great natural laws of living matter, comparable in all ways with
other great generalizations, the first perceptions of which were necessarily
incomplete so far as actual demonstration by experiment or mathematical calculation
is concerned. This theory of Still is deserving of being ranked, within its
own special compass, beside the theory of the chemical and physical basis of
life - a theory that grew in many minds rather than in one. It is, indeed, a
corollary of Darwin's law of natural selection, for it is clear that if all
living organisms had not been preserved through their ancestral immunity to
disease - through this self-protecting mechanism that saved them from disaster
and death by disease - they had never survived at all, the very fact of their
survival being of itself indisputable evidence of the presence in their bodies
of a defensive and curative force - the old vis medicatrix naturae (the healing
force of nature) of the ancient doctors that was ever active and automatically
self-adjusting under favorable conditions. To re-establish these favorable conditions,
when accident had removed them, was the method proposed by Still for the cure
of disease; a method absolutely original with himself, and grounded on the most
conspicuous fact of human consciousness - the tendency of some forms of living
matter to antagonize and destroy certain other forms of living matter, and thus
to survive in the struggle for life-"disease" being mainly a struggle for life
among living forms, as for example, destructive "germs" or tumor cells, on the
one hand, and the normal cells of the body on the other.
GREAT THINKERS LAUNCH MANY IDEAS THAT ARE FOUND WRONG
We have said that Still originated many various physiology which have since
been found to be in theories concerning normal and pathological adequate or
faulty. But in this respect he resembled all other great geniuses in biology
and other sciences. The earlier investigators in all sciences were quite outside
the truth in many, and indeed in most, of their scientific speculations, and
necessarily so. Many osteopaths, while revering the founder of the new system
of healing, have seemed to feel, because Still was right in his two grand principles
of disease and its therapy, that therefore he should not have been wrong in
anything he said about the body and its work, in health and disease. But such
osteopaths are shortsighted and unwise. If Dr. Still had been right in all his
theories he would not have been human, not worthy of human admiration. His errors,
indeed, and he made many, are really a greater glory to his genius than his
two great and true discoveries. Dr. Still's very errors would have been accounted
discoveries if made by a common man. He lived and worked out his theories forty-five
years ago, and earlier. He had thought out a scientific theory to account for
the phenomena of cholera, for example, when other men accounted for them by
the belief that this disease was a visitation of Providence on the sins of men.
His theory of cholera in the light of subsequent discoveries is seen to be untrue,
of course, but to originate any kind of a scientific theory at all of this disease
in that day was the mark of an original, scientific and profound thinker. His
theory of "blood seed", which few of his interpreters have been able to understand,
is an identical theory with that of the contemporaries of Theodor Schwann to
account for the growth of cells in the body. Dr. Still himself was a contemporary
of Schwann, and it is small wonder that the doctors of that day in America could
not understand his meaning when he spoke of "blood seed". The American doctors,
in that day knew nothing of the cell theory of Schwann, or next to nothing.
Now there was in that day current in the higher scientific circles of Europe
a theory of "blood seed", but it was not called by that term. It was known as
the "blastema theory". There are probably not many doctors in America today
who could tell us what the "blastema theory" was. And why should they, when
this theory, like Still's "blood seed" theory, was wiped out by the discovery
made later that all cells originate from one cell (the ovum), and that no cell
arises except as the continuous splitting-by cell division-of previously existing
cells? But the "blastema theory" held that there were in the blood countless
millions of invisible particles floating in a special fluid, the "blastema",
which had the power of growing large and developing into cells. As a matter
of fact, there are in nature certain unicellular animals, such as the organisms
that cause smallpox, that do actually grow from invisible units so small that
they can pass through the pores of a Berkfeld filter. But the cells of the animal
body do not grow in just that way, although the original units or cell development
actually exist in the egg cell and its descendants in this inconceivably minute
form, and it was upon this conception that the German biologist Weissman founded
his wonderful theory of inheritance with its "idants", "ids", "determinants"
and "biophors". Now Still, and the other contemporaries of Schwann, held that
these minute units (afterwards called "gemmules" by Darwin, "granules" by Altmann
and "micellae" and "plastidules" by Haeckel and others), actually floated in
the blood and furnished the origin of the cells of the body. In that much, of
course, Still and the others were in error, but it is at least an indication
of the powerfully original mind of Still that he had hit upon a theory going
to the very origin of the cell, similar in all respects to that of the best
thinkers of Europe of his day. And we need have no doubt at all that Still,
in common with his American colleagues, had no intimate acquaintance at all
with the finer-spun biological theories of the Europe of that day.
Again we must remember that Still was a doctor of the old school and that he
did not altogether rid himself, as his followers have done, of all the old machinery
of the older therapy. We must do him the justice, however, of being consistent
in a thorough way in his rejection of internal drug medication. Indeed he held
that locomotor ataxia was caused by the mercury administered to the syphlitic
rather than by the disease; but this is now known not to be true, although in
his day that speculation of his was quite as justifiable as any other on the
cause of tabes dorsalis.
VAGARIES OF OTHER GREAT SCIENTIFIC REFORMERS
It is interesting to observe, however, that of all the old drastic methods
of therapy which were in full swing in his own day, only one has
retained its vitality, and that is the principle of so-called "counter-irritants".
Blisters and strong irritating plasters are potent in certain pains
and other symptoms, although the reason why is perfectly obscure.
And this principle of counter irritants was perhaps the one prominent
therapeutic method of the old time that Still did not abandon. He
believed, in a limited way, in counter irritants and used them,
sometimes with excellent results, although the results were not
always as sure as the cures he wrought when he stuck to his own
discovery, osteopathy. His scientific errors and vagaries, however,
were remarkably few when compared with the number of similar errors
and vagaries of other great scientific reformers of his own day.
For example, if we look into the life work of the great Johannes
Mueller, founder of modern physiology, and professor of anatomy
and physiology in the University of Berlin (while Still was developing
his earliest dissatisfactions with medical unwisdom) we will find
that perhaps not one of Mueller's wonderful "discoveries" accepted
in that day as true - has stood the test of subsequent investigation.
Mueller wrote whole textbooks of physiology (previously to 1850)
which consisted wholly of experiments and theories all his own.
And yet all that remains of the work of this great genius of science
is the one theory of the "specific energy of nerves". But do we
say therefore that Johannes Mueller is unworthy the monuments the
world has raised to him and of the honor we do him proudly today?
No, indeed. For Mueller's scientific errors and "vagaries" form
the fundamental rock and cornerstone of modern physiological Science,
just as the most striking of Still's errors form the fundament of
modern drugless therapy, with this difference that Still's theory
of immunity has been absolutely demonstrated by every laboratory
in Europe, and his practical application of that theory in osteopathy,
the American science of mechano-therapy, has given to a suffering
humanity a balm unparalleled, and unapproached in the history of
the human race.