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 of osteopathy.

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 than others.

"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 test.

"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 mental disorder.

"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 His work.'"

Results of our treatment are statistically summed up in our fifteenth annual report which is as follows:

Total number of patients entering institution 3,517
Total number of patients leaving institution 3,380
Statistical purposes (excluding some organic diseases, cases other than nervous or mental, and those coming for examination, opinion and advice 1,737
Cases other than nervous or mental  100
Examination, opinion and advice 1,148
Dementia praecox  800
     Recovery  284 (35 1/2%)
Manic-depressive psychosis 615
     Recovery  407 (66%)
Infection and exhaustion psychoses 56
     Recovery 53 (94%)
Toxic psychosis 35
     Recovery 33 (94%)
Psychoneuroses 212
     Recovery 165 (77%)
Presenile delusional psychosis 6
     Recovery 3
Traumatic psychosis 4
     Recovery 4
Apoplectic confusional psychosis 2
     Recovery 2
Incipient arteriosclerotic dementia 5
     Recovery 5
Incipient presenile dementia 2
     Recovery 2
Organic diseases 395
Cases other than nervous or mental 100
Examination opinion and advice 1,072

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 in words.

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.