Articles On Manual Therapy
Fifteen Years at Still-Hildreth
A. G. Hildreth, D.O.
The Journal of Osteopathy
Volume 36, pages 518-521
As the American School of Osteopathy at Kirksville was the pioneer
in teaching to the world osteopathy, the Still-Hildreth at Macon
has pioneered in the treatment of nervous and mental diseases osteopathically.
It would take much valuable space to go into the details that led
up to the organization of this great work, but perhaps the profession
would be interested in knowing just how it all came about.
The property was created with German money. The late Colonel
Blees fell heir to something like three millions dollars and having
lived in Macon and liking the people of the town he decided when
this money came to him that this was the place to spend it and he
conceived the idea of a military school over which he should preside.
It was a great undertaking, a beautiful scheme, and his constructive
work in these splendid buildings was as fine and as nearly perfect
as any with which it has ever been my privilege to come in contact.
After more than thirty years there is scarcely a flaw in the buildings.
The material was first class, the construction first class and in
fact the entire expenditure was guided and handled evidently by
a master mind.
Dr. Still or I could hardly have dreamed that our profession should
ever be able to own and use such a property for the advancement
Back in the early years of osteopathy, associated as I was with
its founder at Kirksville, I witnessed many things that almost seemed
the product of a superhuman mind. Oftimes I said in those
days that, in my judgment, our profession was divinely guided.
The same thought came to me when this Macon proposition was presented
to me. Dr. Harry and Dr. Charlie Still had conferred with
the owners of the property. They promised to back an institution
of this kind and assist me if I would take charge and stay on the
ground to guide its destiny.
My daughter and I, with Dr. Walter E. Bailey of St. Louis, arrived
at Macon or rather at Hildreth, as our flag station has been named,
on the evening of February 26, 1914. We had sent on in advance
a trained nurse, Miss Mable Burger, and a matron, Mrs. Kaiser, also
a cook and his wife, colored people from Webster Groves I had known
for some time. We entered the building about seven o'clock
in the evening and found our dinner waiting for us. At the
table were the five of us who came here to open the institution
and we were waited upon by the cook and his wife. The building
seemed a barn-like place and rather lonesome, but we got busy and
on the fourth day of March we received the first patient.
By the end of the month we had sixteen patients, and at the end
of a year over fifty patients. In less than seven years the
number reached a hundred seventy-two.
The work was new to us and patients were few at first but it was
not long until we know - as we had every confidence before opening
the institution - that osteopathy was going to prove to be a valuable
treatment for the mentally sick.
It was this confidence that led to the founding of the institution.
Many of my best friends said to me that they did not see how, at
my age, I could give up my splendid practice in St. Louis and undertake
this kind of work. Though we were pioneering I had no doubt
of success. We were entering a broad and sadly neglected field
in which good results would guarantee the future of the institution.
That the work has proven satisfactory goes without questioning,
although we are anxious to do still better in the future.
Our theories of etiology and treatment of nervous and mental disorders
are outlined in our newest pictorial booklet, which has just come
from the printers and from which I shall now quote.
"To what are nervous and mental breakdowns due? This cannot
be answered in a single word. The one word, however which
comes nearest, is 'strain' - physical strain, mental strain.
Mental overwork, grief, worry, religious excitement, etc., physical
overwork, injury to head or spine, exhaustion from hemorrhage, operations,
childbirth, etc., acute and chronic infections, and diseases of
metabolism, are causes.
"Physiological crises, such as puberty and menopause, inheritance
of nervous instability, toxins or poisons, whether taken as drugs,
formed by bacteria, absorbed from sluggish bowels, or formed in
the tissues and retained in the blood through failure of elimination
- all these are possible factors the production of mental disorders.
Of these, heredity is just a predisposing cause. Nervous instability
is all that is inherited. Probably every case is the cumulative
result of a number of causes acting in concert.
"Break into the circle of causes. Remove all that are removable.
Leave the rest to nature. Thus assisted, she is usually able
to 'come back.' Such is the philosophy of treatment of Still-Hildreth.
"In the individual case intelligent treatment directed to this
end presupposes a thorough knowledge of the particular causes operative
in the case. This involves a complete history of the patient
and a thorough examination: physical, neurological, mental, and
laboratory, for which our facilities are excellent.
"Ten to fourteen days are usually required to make a report of
examinations and a provisional diagnosis. Two insurance companies
have pronounced such a report to be one of the most complete records
they had ever seen.
"The value of such examination is three-fold. It makes possible
a definite diagnosis, reveals the line of treatment needed, and,
when repeated, affords a check upon the results of treatment and
progress of the patient. Diagnosis is important because of
its bearing on prognosis, some conditions having a better outlook
"Treatment, however, is of far more importance than diagnosis.
It is well to know that the patient's trouble is so-and-so, and
give it a long name, but it is better to know what to do about it.
"Cure is our motto. Care is essential and we furnish the
best, but it is incidental and secondary to treatment, designed
to cure by removal of cause. A general outline of these has
been given, but a most fundamental one has not been emphasized.
These are spinal lesions. These are really the basis of some
of the other causes. Lesions directly disturb the nerves controlling
the blood supply and hence nutrition of the brain. Lesions
disturb the function of the digestive organs and hence the general
nutrition, including that of the brain.
"Lesions impair bowel activity, allowing the absorption of poisons
which affect the body and brain. Lesions impair kidney function,
decreasing elimination of urea and other body poisons. Lesions
predispose the body to infections and maintain them in a chronic
state, with absorption of bacterial poisons. Lesions disturb
the ductless glands, whose secretions may thus become toxic.
A starved and poisoned brain cannot function well. So the
mind breaks down under a strain that normally would not affect it.
"Treatment, therefore, is primarily adjustment of structure to
restore normal function. This cannot be done at once.
Most lesions require persistent efforts at correction for some time.
Complete correction restores absolute normality of function, but
partial correction brings steady improvement.
"Until results of this primary treatment appear, something else
is needed for immediate assistance to nature where she has 'fallen
down' on the job. For this, consequently, other natural methods
are used as adjuncts.
"Many patients have a history of long continued constipation which
evidence of resulting autointoxication, which is verified by laboratory
tests. It is not unusual to restore normal function to the
bowel, even after years of persistent constipation, by removal of
the blockage to its nerve supply.
"Till this is done, some assistance is necessary. For it
our main reliance is colonic irrigation, by which the colon is thoroughly
cleansed by large quantities of normal salt solution, flowing in
and out through a Y-tube. The value of this is obvious.
"Hydrotherapy is another valuable aid for which we are equipped.
Baths and hot packs are used to quiet the nerves, to induce sleep,
and especially to stimulate elimination through kidneys and skin.
Complete failure of kidney elimination quickly results in death.
"Partial failure causes retention of body poisons in the blood
in amounts proportional to the degree of failure. The amount
of retention is ascertained by measuring the urea, etc., in the
blood and kidney efficiency is measured by the phenolsulphonephthalein
"Thus we find many incoming patients with more or less impairment
of kidney efficiency and the resulting toxemia. By packs
and baths we promote elimination of these toxins during the time
required for the primary corrective work. Results are measured
in the laboratory, well as reflected in the patient's symptoms.
Even in cases with organic disease of the kidneys, if this is not
too extensive, such improvement may result.
"Nature is generous, equipping us with reserves in organ and tissue.
A man can live and enjoy health with only one kidney if that be
sound. Likewise with disease in both he can get along if the
undamaged tissue functions properly. Such a case, thus
treated, may show improved renal function, decrease of albumin in
the urine, reduction of high blood pressure, and recovery from the
"Diet, of course, is an important aid to treatment. A well
balanced, nourishing dietary is necessary to build rich blood, which
is the foundation of health. Such a diet we seek to provide
for our general dining rooms, with plenty of green vegetables and
fresh fruit the year round.
"We follow no food fads nor expect any one dietary line to cure
everything. Upon occasion we use temporarily a milk diet,
a fruit diet, or a vegetarian or low protein diet, but only for
special conditions revealed by our examinations.
"Too many patients leave before our work has had time to produce
results. Not all possess the necessary faith and patience
to await nature's response. But, even so, our results have
been remarkable. We, like Dr. Still, utilize nature's laws
of health. They are not hidden or mysterious. This fact
he emphasized when he said, 'The God I worship demonstrates all
Results of our treatment are statistically summed up in our fifteenth
annual report which is as follows:
|Total number of patients entering
|Total number of patients leaving institution
|Statistical purposes (excluding some organic
diseases, cases other than nervous or mental, and those coming
for examination, opinion and advice
|Cases other than nervous or mental
|Examination, opinion and advice
||284 (35 1/2%)
|Infection and exhaustion psychoses
|Presenile delusional psychosis
|Apoplectic confusional psychosis
|Incipient arteriosclerotic dementia
|Incipient presenile dementia
|Cases other than nervous or mental
|Examination opinion and advice
The time required for recovery varies greatly, even in patients
of the same type. The great majority of recoveries take place
in from three to twelve months. A year does not exhaust the
possibilities, however. Of sixteen manic-depressive cases
that stayed over a year nine recovered and the time required ranged
from thirteen to thirty months. There have been seven dementia
praecox recoveries requiring more than a year and ranging from thirteen
months to five years.
Instead of the work being a hardship it has been a continuous joy
from start to finish, a joy through service. While many times
our problems have been heavy and our responsibilities grave and
great, yet the results obtained in cases pronounced incurable have
brought into the work a pleasure and a satisfaction inexpressible
I wish that every man and woman in our profession realized
how much can be accomplished in the cure of this class of conditions
under proper treatment and surroundings. Such knowledge would
be a beacon of hope to many thousands who have been told there is
no hope for their loved ones who are mentally unbalanced.
Time, I believe, will prove what our profession is doing and can
do and I hope and pray as I believe it must, the time will come
when the world will recognize osteopathic treatment for the insane
as a genuine scientific system.
This article is written upon the request of the editor and not
with any thought of my own individual association with this institution
or the work, but with a gladness in my heart I can't express in
words over the fact that our great profession successful in so many
other fields has made good in this newer field also. It is
a source of satisfaction that fills my life with joy.