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Principles of Osteopathy
Great strides have been made during the past twenty-five years in the practice of medicine. The relative posstions formerly held by drug therapy and surgery have been completely reversed. The concoctions of the pharmocopoeia, with their vague and uncertain effects upon human tissues and functions, no longer entice the earliest seeker after medical truths to spend a lifetime experimenting with substances which are absolutely foreign to the human body. There was a time, not far away, when that person who treated human diseases by manipulation, water, diet and general hygiene was considered to be the chief of impostors. Go a little farther back in the history of medicine and we see surgery dishonored because it was mechanical, not mystical enough for the ponderous minds whose fort it was to deal with strange substances of the animal, vegetable and mineral kingdoms. During all the years in which drug-therapy flourished there were a few real scientists who devoted time and talents to the structure of our bodies and the function of each part. Discoveries came slowly along these lines because the majority of medical men were concentrating their energies on ferreting out the effects of drugs. Facts in anatomy and physiology which are so patent to us at this time remained obscure for centuries, simply because there was no thought of studying the form and action of tissues, while all nature outside of our own bodies seemed to be a grand laboratory of specifics for human ailments. If osteopathy had been born fifty years ago, it would have died because the popular and scientific minds were not in a condition to receive it. Even the time at which it was born, scarcely thirty-five years ago, was hardly ripe for this new departure in medicine. Twenty years easily cover the period of its active history. A Scientific Growth. - There is one distinctive point about osteopathy which should be especially emphasized: It is not an empirical system; nothing is done on the cut and dry plan. It has been developed in a purely scientific way. We might observe the action of the human body in health and disease indefinitely without securing any exact data to pass on to the next generation of observers if we fail to know the structure of the body. A physician may learn many things in an empirical way which are very poor assets for science. The strange part of medical history, to the modern investigators is the fact that discoveries in anatomy and physiology, which are of such vital importance to the successful treatment of human diseases, were left stored away between the covers of books, not deemed of any value except to whet the mind of the dilletante in medicine. Osteopathy as a distinct system of medicine has grown to its present proportions at a time when the older schools of medicine are making radical changes in their therapeutic procedures, e. g.. serum-therapy. In spite of all these so-called scientific advances in drug-therapy, osteopathy has made steady advances into public favor, thereby showing that it is fully able to compete with the older systems of practice. The Founder of Osteopathy. - Dr. A. T. Still, of Kirksville, Mo., is the honored founder of this system of therapeutics. His work was in studying the structure of our bodies directly, and thus gaining an accurate knowledge of how bones, ligaments and muscles, blood vessels, glands and nerves are placed. Then he sought that department of knowledge which we call physiology, and learned how these tissues act in health. Having had previous training in treating diseases by the drug method, he was slow to discard the old method for one which had never been tried, even though it had good scientific reasons back of it. But the substitution did take place by degrees until his system of therapeutics no longer depended on the use of drugs. It seems to be a popular idea that it is necessary for the founder of a system to have a creed or statement of belief. We do not doubt but that it is good for us at times to try to put our beliefs in writing, not to form a fixed position, but just as the architect draws many plans to gradually develop his mental pictures. These statements usually contain the truth about our work so far as we know it. We can thus see how far we have advanced and realize that we have much to learn. Dr. Still has, from time to time, expressed the result of his studies, that is, the observed facts upon which he has built his system of therapeutics. In 1874, Dr. Still stated his observations as follows: "A disturbed artery marks the period to an hour, and minutes when disease begins to sow its seeds of destruction in the human body. That in no case could it be done without a broken or suspended current of arterial blood which, by nature, is intended to supply and nourish all nerves, ligaments, muscles, skin, bones and the artery itself … The rule of the artery must be absolute, universal, and unobstructed, or disease will be the result … All nerves depend wholly upon the arterial system for their qualities, such as sensation, nutrition and motion, even though by the law of reciprocity they furnish force, nutrition and sensation to the artery itself." Definitions. - Many definitions have been formulated and published to the world. Each one tends to limit one's conception of osteopathy in some particular. A definition always limits the thing defined, therefore, no definition of osteopathy can be complete, because we are dealing with a principle, the universality of which no one knows. Whereas, less than seven years ago, it was thought that osteopathy was an excellent method of treating chronic ailments, we now find osteopaths working day and night at the bedside of the acutely sick. Thus does it spread and become thoroughly recognized as a system applicable to all diseases. In order to bring before the student as full and comprehensive an idea of the scope of osteopathy as possible, a series of definitions are quoted. These definitions have been taken from current osteopathic literature and are credited to their respective authors. One of the short paragraphs in Dr. Still's auto-biography is sufficient to give a clear understanding of his idea of the human body. "The human body is a machine run by the unseen force called life, and that it may be run harmoniously, it is necessary that there be liberty of blood, nerves and arteries from the generating point to destination." The following definition is one which has been used in the American School publications for a long time: "Osteopathy is that science which consists of such exact, exhaustive and verifiable knowledge of the structures and functions of the human mechanism, anatomical, physiological and psychological, including the chemistry and physics of its known elements as has made discoverable certain organic laws and remedial resources, within the body itself, by which nature, under the scientific treatment peculiar to osteopathic practice, apart from all ordinary methods of extraneous, artificial, or medicinal stimulation, and in harmonious accord with its own mechanical principles, molecular activities, and metabolic processes, may recover from displacements, disorganizations, derangements, and consequent disease, and regain its normal equilibrium of form and function in health and strength." Mason W. Pressly, A.B., Ph. D., D.O. "Osteopathy is that science of healing which emphasizes, (a) the diagnosis of disease by physical methods with a view to discovering not the symptoms but the causes of diseases, in connection with misplacements of tissue, obstruction of the trends and interference with the forces of the organism; (b) the treatment of diseases 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 part, 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 fractured or dislocated bones, repairing lacerations and removing abnormal tissue growths or tissue elements when these become dangerous to the organic life." J. Martin Littlejohn, LL. D., M..D., D. O. "Osteopathy is a school of mechanical therapeutics based on several theories. 1. Anatomical order of the bones and other structures of the body is productive of physiological order, i. e., ease or health in contradistinction to disease or disorder which is usually due, directly or indirectly, to anatomical disorder. 2. Sluggish organs may be stimulated mechanically by way of appropriate nerves (frequently by utilizing reflexes) or nerve centers. 3. Inhibition of over-active organs may be effected by steady pressure substituted for the mechanical stimulation mentioned above. 4. Removal of causes of faulty action of any part or organ is the keynote of the science." C. M. Case, M.D., D.O. "Osteopathy is that school of medicine whose distinctive method consists in (1) a physical examination to determine the condition of the mechanism and functions of all parts of the human body, and (2) a specific manipulation to restore the normal mechanism and reestablish the normal functions. This definition lays stress (1) upon correct diagnosis. The osteopath must know the normal and recognize any departure from it as a possible factor in disease. There is not one fact known to the anatomist or physiologist that may not be of vital importance to the scientific osteopath. Hence a correct diagnosis based upon such knowledge is half the battle. Without it scientific osteopathy is impossible and the practice is necessarily haphazard or merely routine movements. The definition lays stress upon (2) removal of the cause of disease. A deranged mechanism must be corrected by mechanical means specifically applied as the most natural and only direct method of procedure. This work is not done by any of the methods of other schools. After the mechanism has been corrected little remains to be done to restore function, but stimulation or inhibition of certain nerve centers may give temporary relief and aid nature. The adjuvants used by other schools, such as water, diet, exercise, surgery, etc., are the common heritage of our profession and should be resorted to by the osteopath if they are indicated." E. R. Booth. Ph. D., D.O., Ex-President A.O.A. "Osteopathy is that science or system of healing which, using every means of diagnosis, with a view to discovering, not only the symptoms, but the causes of diseases, seeks, by scientific manipulations of the human body, and other physical means, the correcting and removing of all abnormalities in the physical relations of the cells, tissues and organs of the body, particularly the correcting of misplacements of organs or parts, the relaxing of contracted tissues, the removing of obstructions to the movements of fluids, the removing of interferences with the transmission of nerve impulses, the neutralizing and removing of septic or foreign substances from the body; thereby restoring normal physiological processes, through the re-establishment of normal chemical and vital relations of the cells, tissues and organs of the body, and resulting in restoration of health, through the automatic stimulation and free operation of the inherent resistant and remedial forces within the body itself." C. M. Turner Hulett, D.O. "Osteopathy is that science which reasons on the human system from a mechanical as well as a chemical standpoint, taking into consideration in its diagnosis, heredity, the habits of the patient, past and present; the history of the trouble, including symptoms, falls, strains, injuries, toxic and septic conditions, and especially in every case a physical examination by inspection, palpation, percussion, ausculation, etc., to determine all abnormal physical conditions; the treatment emphasizing scientific manipulation to correct mechanical lesions, to stimulate or inhibit and regulate nerve force and circulatory fluids for the recuperation of any diseased part, using the vital forces within the body; also the habits of the patient are regulated as to hygiene, air, food, water, rest, exercises, climate and baths; such means as hydrotherapy, electricity, massage, antidotes and antiseptics, and suggestion sometimes being used as adjuncts." Chas. C. Reid, D.O. The above definitions have nearly all been taken from the journal of the American Osteopathic Association. Osteopathic Diagnosis. - Physical diagnosis is and al-ways will be the leading factor in the success of osteopathic practitioners. This ability to take hold of an ailing human being and detect the disturbing factor in it is the highest attainment of the physician. Osteopathy has developed the art of palpation to a wonderful degree. Basing this art on a definite knowledge of structure and function makes it the chief reliance in diagnosis. Every physical diagnosis begins with palpation and proceeds with ausculation and percussion, and not failing to use chemical and microscopical methods when necessary. The student must learn to use his sense of touch continually, in fact, learn to see with his fingers. Add to this development of touch a training in chemical and microscopical analysis of secretions and excretions of the body, and we have a practitioner thoroughly equipped to make an accurate scientific diagnosis. Osteopathic Therapeutics. - Osteopathic treatment is based on this kind of physical diagnosis which we have just described. It takes into account the fact that the organism is a self-recuperating mechanism and requires proper food, proper surroundings, and perfect activity of every tissue, especially the blood. Thus we divide treatment into three divisions, (1) manipulation for the purpose of correcting the mal-position of any tissue, whether that tissue be bone or blood; (2) proper feeding, i. e., dietetics; and (3) proper surroundings, i. e., hygiene. If the condition of the body is such that none of the three methods just mentioned will right the difficulty, i. e., if there are broken bones, ruptured muscles and connective tissues or false growths, we can then use surgical means. Surgery is a part of the osteopathic system, just as it is of all systems of medicine. The chief assurance lies in the fact that the osteopathic system is very con-servative as regards the use of the knife. Osteopathy includes all those qualities which make up a successful system; its diagnosis is accurate and its treatment is comprehensive, including scientific manipulations, scientific dietetics, hygiene and surgery. In a recent article in the American Monthly Review of Reviews, the following sentences appear: "With but few exceptions, the entire vegetable and mineral kingdoms have given us little of specific value; but still, up to the present day, the bulk of our books on materia medica is made up of a description of many valueless drugs and preparations. Is it not to be deplored that valuable time should be wasted in our student days by cramming into our heads a lot of therapeutic ballast." This is probably the most recent statement of this kind in the public prints. It substantiates the position taken by the osteopathic colleges. We feel justified in claiming that osteopathy today occupies a position which every other system of medicine must come to sooner or litter. It is broad enough and liberal enough to accept truth wherever demonstrated. Its foundations being laid in the basic sciences, and its treatment never departing from the facts of these sciences, make it a system of lasting worth and capable of adding an entirely new conception of the phenomena of life to medical literature. The formation of the name osteopathy (from osteon, bone, and pathos, suffering) seems to be as perfect a descriptive name as it is possible to form which world cover the basic principle of the science. The bones are the foundation upon which all the soft tissues are laid, and the osteopath makes all his examinations, using them as fixed points from which to explore for faulty arrangement. The name does not mean bone disease, but since the osteopath finds many diseases resulting from irritation due to slightly displaced bone, the name is used in the sense of disease caused by bone. We do not consider that all diseases are caused by displaced bone, but it is a cause which has heretofore been overlooked. We recognize that there are many causes of disease, and do not wish to be understood as trying to fit fact to theory, but as a result of observing certain facts, this basic principle of osteopathy has been made clear. We believe that health is the natural state, and that this condition is bound to be maintained so long as every cell has an uninterrupted blood supply, and its controlling nerve is undisturbed. Therefore, the first effort of the osteopath is to remove all obstructions to blood and nerve supply, feeling certain that when these obstructions are removed, health will follow. Hilton in his lectures on "Rest and Pain," which are considered medical classics, has expressed himself forcibly on this subject, as follows: "It would be well, I think, if the surgeon would fix upon his memory, as the first professional thought which should accompany him in the course of his daily occupation, this physiological truth - that nature has a constant tendency to repair the injuries to which her structures may have been subjected, whether those injuries be the result of fatigue or exhaustion, of inflammation or accident. Also, that this reparative power becomes at once most conspicuous when the disturbing cause has been removed; thus presenting to the consideration of the physician and surgeon a constantly recurring and sound principle for his guidance in his professional practice." Every system of curing human ills which is based
on the known facts of anatomy and physiology will last, because it is true.
When systems of drug medication are known only as history, osteopathy will
be ministering to the human race, because it knows no other path than that
which leads to greater truths in physiology and anatomy.
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