THE PRINCIPLES AND PRACTICE OF OSTEOPATHY.
Doctor, no medicine. We are machines made to live - organized
expressly for that purpose. Such is our nature. Do not counteract
the living principle. Leave it at liberty to defend itself, and
it will do better than your drugs. - NAPOLEON.
Enough has been said about Osteopathy in the preceding chapters
to give the reader a general idea as to its principles and their
applications, and to differentiate it from all other systems. All
knowledge pertaining to protoplasm, to the cell, to all varieties
of tissues as to structure and function, to that all important element
the life principle, etc., is involved in the fundamental principles
enunciated, and is valuable to the osteopath. No attempt is made
here to discuss these profound subjects in relation to Osteopathy.
Only a few of the gross facts, as it were, are given.
It is doubtful whether or not a satisfactory definition of Osteopathy
has ever been presented, and it may not yet be possible to make
a formal specific statement as to what it is, because its limitations
are not yet established. New fields are opening up daily, rich in
possibilities for Osteopathy. There are but few intelligent osteopaths
who have not found cases which they have successfully treated, but
which were, at first, thought to be beyond the domain of osteopathic
science and art. The three fundamental principles upon which Dr.
Still founded Osteopathy, as shown in Chapter II, are the viewpoints
from which every true osteopath surveys his work. They are fixed,
and every conceivable case bears a certain relation to those points,
which relation can be established with almost geometric precision.
Many attempts have been made to define Osteopathy. The late Dr.
G. D. Hulett made the following statement on page 18 of his "Principles
"All systems and sciences, whether related to healing or other
aspect of human endeavor, are a result of growth. Growth presupposes
a beginning less mature than the end. Hence it were presumption
at the present time to attempt to set definite limits to the science
of Osteopathy. Professor Ladd, of Yale, states a very important
fact when he says that the proper definition of a science is one
of the latest and most difficult achievements of that science. Recognizing
the extreme youth of Osteopathy, we must be content with only a
provisional setting of limitations in any attempt at a statement
of its constituent elements. Admitting this to be the case, yet
it is not deemed presumptuous to attempt to formulate in a concise
manner the essential ideas in the form of what may be called a definition,"
On page 20, he suggests the following definition, which he elaborates
in the chapters that follow:
"A system of therapeutics which, recognizing that the maintenance
and restoration of normal function are alike dependent on a force
inherent in protoplasm, and that function perverted beyond the limits
of self-adjustment, is dependent on a condition of structure perverted
beyond those limits, attempts the re-establishment of normal function
by manipulative measures designed to render to the organism such
aid as will enable it to overcome or adapt itself to the disturbed
From many other proposed definitions the following are selected:
"Osteopathy is that system or science of healing that uses
the natural resources of the body as curative agents. To this end
means are used for the adjustment of structural conditions and relations
that may have become abnormal, in order to insure the proper preparation
and distribution of the fluids and forces of the body, and to secure
the co-operation of functional activities, so as to promote harmony
within the body mechauism." – J. Martin Littlejohn, Ph.
D., M. D., D. O.
"Osteopathy is a system of medicine characterized by close
adherence to the physiological axiom that perfect health depends
on a perfect circulation and perfect nerve control in every tissue
of the body. Its etiology emphasizes physical perversions of tissue
relations as causes of disease. Its diagnosis is mainly dependent
on the discovery of physical lesions by means of palpation. Its
therapeutics comprehends (1) manipulation, including surgery, for
purposes of readjusting tissue relations; (2) scientific dietetics;
(3) personal and public hygiene." - Dain L. Tasker, D. O.
"Osteopathy is a system of treating disease without drugs
by the use of the hands to adjust all parts of the human mechanism
to perfect mechanical relations. It is that science which finds
in disturbed mechanical relations of the anatomical parts of the
body the causes of disease, and which is employed to cure disease
by applying technical knowledge and high manual skill to the correction
of all disturbed relations occurring in the mechanical arrangement
of the body. It is a science founded upon the principles of anatomy
"The word does not mean the treatment of the bones, nor of
bone diseases. It was used as a name because the founder discovered
the importance of disturbances in the bony framework of the body
in causing disease. He studied the skeleton as the foundation of
anatomy, upon which science he grounded his system. The meaning
of the word applies not only to derangements of bony parts, but
as well to disturbed relations of ligaments, tendons, blood-vessels,
muscles, nerves, and of any body tissue." - Journal of Osteopathy.
"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 disease, 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. T. Hulett,
The present writer ventures to suggest the following: Osteopathy
is that school of medical practice 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; (2) a specific
manipulation to restore the normal mechanism and re-establish the
normal functions; and, (3) the adoption of all hygienic measures
conducive to the restoration and maintenance of health. This definition
lays stress upon the following points: (1) Correct diagnosis based
upon a physical examination. 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 osteopath. Hence a correct
diagnosis based upon such knowledge is necessary. (2) Removal of
the cause of disease. A deranged mechanism must be corrected by
mechanical means specifically applied, which is 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 lie done to restore function; but stimulation
or inhibition of certain nerve centers may give temporary relief
and aid nature. (3) Wholesome living, both in sickness and in health.
All the means employed by other schools, including proper use of
pure air, water, food, heat and cold, exercise and rest, cleanliness
and surgery, and public hygiene and sanitary science, are the common
heritage of all schools, and especially in line with osteopathic
theory and practice.
It will be seen that practically all of the above definitions lay
stress upon diagnosis in the sense of determining the first cause,
the causa causans, and the relations between it and the secondary
causes which often determine the most noticeable symptoms. This
is a new principle in diagnosis, absolutely unlike any ever applied,
except in occasional cases, by any other school of physicians. The
definitions also provide for treatment in accordance with the diagnosis;
hence the treatment suggested, except in occasional cases, is absolutely
unlike any other that has ever been proposed.
It is not claimed that no one ever recognized an osteopathic principle
or put it into practice before Dr. Still. History shows that many
had grasped and applied principles essentially osteopathic long
before Osteopathy, or anything like it, as a complete system ever
entered the human mind. But in almost every case where the principle
was seen, its application was never dreamed of. Men in all ages
of the world had observed the force of steam, and many of them had
seen it lift the kettle lid as often as Watt had; but only he thought
of developing a machine which would enable him to use steam whenever
power was wanted. So others knew much of anatomy, physiology, and
pathology, but only Dr. Still thought of developing a system based
upon that knowledge which would enable him to cope with all disease
to which the human body is heir.
There is probably no one thing more noticeable in medical literature
today than the almost universal failure to recognize the osteopathic
idea that diseased conditions are, or ever may be, due to derangement
of form and consequent disturbance of f unction. Any change of size,
texture, structure, position, relation, is a change of form, an
anatomical derangement, a lesion in the osteopathic sense, a possible
cause for disease. A failure of any part of the body to do its duty
is a disturbance of function, generally caused by some derangement
of form. These are essential osteopathic ideas, but they are almost
completely ignored by the drug schools of practice; hence the firm
basis upon which Osteopathy rests in contrast with those systems
based upon symptoms in both diagnosis and practice.
It is remarkable how little the statement of the fundamental ideas
underlying Osteopathy have changed since first enunciated by Dr.
Still in 1874. Yet not surprising, because he stated in plain language
the truth, and truth then is the same now and will not change with
the lapse of time. Dr. Still was the first to discover and announce
a great truth, - a scientific fact, - the one upon which Osteopathy
is built, and restatements of that truth must always mean the same
thing, no more, no less, or the language in which it is stated is
at fault. Chapter II contains a statement of those fundamental principles
from which Osteopathy was evolved, and it is not necessary to repeat
them here. A later presentation of the subject by Dr. Still appears
in the Journal of Osteopathy for August, 1902. It serves as a definition
and makes clear the whole theory and practice as viewed by the founder
of the science:
"Disease is the result of physiological discord. With this
fact established in the mind of the doctor of Osteopathy as a truth,
he is warranted then in hunting the facts that would prove the position,
that disease is the result of physiological discord in the functioning
of the organs or parts of the physiological laboratory of life.
Thus, as an explorer or seeker of the cause of disease he would
naturally reason that the variations from the physiological perfection
would naturally be found in disordered nerve connections to the
degree of breaking or shutting off the normal circuit of nerve force
from the brain to any part of the body that should be sustained
by that force when normally conducted to any organ as the power
necessary to its process of vital functioning. If this be true,
there is nothing left in his procedure but to find the break or
obstruction to the natural passage of blood or any other fluid that
is necessary to a normal condition, which is health itself. Thus,
the physician of any school of the healing art must know and act
upon the philosophy that disease is the result of physiological
discord. The cause of disease can be traced to bony variations from
the base of the skull to the bottom of the feet, in the joints of
the cervical, dorsal, and lumbar vertebrae, the articulations with
the sacrum, also the arms and lower limbs. Strains by lifting, jolts,
jars, falls, or anything that would cause any organ of the chest
or abdomen to be moved from its normal to an abnormal position,
is cause sufficient to confound the harmony of natural functioning
of the whole viscera both above and below the diaphragm and be the
cause of an unhealthy supply of nerve fluid and force to the limbs
and the organs of the body both internal and external with the brain
included. Thus, we have given about what we consider a short philosophical
definition of what we mean by the word Osteopathy. We use the bones
as fulcrums and levers to adjust from the abnormal to the normal
that the harmonious functioning of the viscera of the whole body
may show forth perfection, that condition which is known as good
DR. A. T. STILL THE FIRST OSTEOPATH.
All history points to the fact that the measures used by osteopaths
were not used, except in a few isolated and generally obscure instances,
under the name Osteopathy, massage, manual therapeutics, bone setting,
or any other appellation, before they were employed by Dr. A. T.
Still. Furthermore, it is not practiced in 1905, by any except graduates
of regularly established schools of Osteopathy. It is true that
certain manipulative methods resembling Osteopathy are used by some
who have taken a correspondence course or read an illustrated book;
but they generally fall so far short of the osteopathic idea that
it is as unreasonable and as incorrect to speak of there as osteopaths
as to call a layman who gives a drink of catnip tea to a sick child
a doctor, or one who takes a little splinter out of a finger or
binds up a wound, a surgeon. Yet in a number of cases the essential
facts of Osteopathy have forced themselves to the attention of thoughtful
men; but not one of them, till Dr. Still, had the grasp of intellect,
the accuracy of knowledge, the persistency of purpose, the thirst
for truth, the desire to relieve suffering, the love for man, and
the confidence in God to enable him to formulate those facts, and
through them establish a complete system of therapeutics.
OTHERS APPROACHED THE OSTEOPATHIC IDEA.
That others came near grasping the osteopathic idea is evidenced
by the following taken from an article in the Osteopathic World
for July, 1903, on "Osteopathic Forerunners," by A. A.
Erz, of San Francisco. His translation is from "Der Arzt als
Hausfreund" ("The Physician as a House Friend"),
by Dr. S. Rupprict, fourth edition, published at Glogan, in 1861.
"When we consider that through the nerves alone the vital force
is diffused over the whole body and that on not only the sensation
and motion, but also the, nutrition, the making of the blood and
juices, every secretion and excretion, in short, the whole animal
household, are depending, and considering that the spine is the
root of diversified nerve branching; thus one will understand not
only how highly important, but also how very various the disturbances
of our health can be, as being based on a morbid or abnormal condition
of the spine. Every only somewhat essential part of our body has
its own peculiar nerves on which depend its function as well as
its sensibility; and all have their separate origin in different
parts of the spine. Now, if these parts of origin become diseased
or affected, the whole nerve at the same time becomes diseased;
however, only at its end, i.e., at that portion for which it is
originally intended this diseased condition is noticed by observing
that either sensation, or motion, or the special function of that
part or organ of our body appears to be disturbed, in consequence
of which either violent pain or convulsions and cramps, or other
disturbances in life of that particular tissue will appear; because
its life supporting and regulating force is morbidly changed or
suppressed. Thus the throat, the heart, the lungs, the stomach,
the liver, the bladder, the uterus, the limbs, etc., may get into
diseased condition, just as that portion of the spine is diseased
or affected whence the respective nerves belonging to that particular
part of the body take their origin. Such a disturbance, however,
is very easily and quite often produced by an inflammatory irritation,
which has this peculiarity that the pain is usually insignificant
in the back and may indeed be wanting there altogether, and that
it can only be perceived by gently pressing every single vertebra
of the whole spine from the neck down. Only then the patient often
feels but a slight sensation, be it at one or more vertebrae; often,
however, a very severe pain is felt, which as quick as lightning
is transmitted to the suffering part in a distance. Yes, indeed,
sometimes the most intense pains in other parts may bring the patient
to the point of despair without imagining that the cause of this
could be looked for in the back. This is actually one of the principal
reasons why the trouble very often is not understood, and the condition
of the spinal column is overlooked, although there is nothing easier
than to come to an understanding about that, because anybody can
soon locate the sore spot in a patient by means of the pressure
mentioned. With troubles of the head, for instance, in case of vertigo,
or buzzing in the ear, or disturbed eyesight, etc., one must not
neglect to examine carefully also the upper vertebrae of the neck
by means of that pressure described already.
"From this rather superficial allusion it must be evident
that there is hardly a disease the origin of which may often be
due to no other cause than such an inflammation or irritation of
the spine, or a spinal lesion of some kind, and certainly, far more
important than the feeling of the pulse, the examining of the tongue
and of the urine, is the examination of the spine, as mentioned
above. I have seen how approaching amaurosis, dangerous hemorrhages
of the uterus, malign stomach troubles, leukorrhea, pulmonary consumption,
even recurrent miscarriages were caused by such spinal lesions,
and often have I been fortunate enough - only through my means of
correctly recognizing and locating the seat of the trouble to render
speedy relief where the patient had been suffering for years."
Dr. Erz comments on the above as follows:
"He does not tell us what further osteopathic use he made
of his discovery, and in what his peculiar treatment - if he did
have any consisted. He may have had some peculiar physical treatment
of his own, and may have kept the secret for himself. Finally he
recommends the old-time customary bleeding or an application of
cantharides, or a blistering salve, etc."
The above statement by Dr. Rupprict was doubtless read by thousands
of the most learned doctors half a century ago. But it probably
made no impression whatever upon most of them. They continued with
their dosing, bleeding, and. other anti-physiological methods, and
looked with contempt upon any treatment strictly in accord with
the announced facts of anatomy and physiology.
Most physicians are more or less familiar with Hilton's great work
on "Rest and Pain." It teems with thoughts suggestive
to the osteopath. Dr. J. M. Littlejohn, in an article in the Boston
Osteopath for February, 1901, brings out so clearly the fact that
Drs. Hilton, Martyn, and Embleton grasped very clearly certain facts
in anatomy essential to Osteopathy, yet never applied them, that
he is quoted at length:
"Hilton says that ‘pain in the anterior and lateral
parts of the head, which are supplied by the fifth nerve, would
suggest that the cause must be somewhere in the area of the distribution
of the other portions of the fifth nerve. So if the pain be expressed
behind, the cause must assuredly be connected with the great or
small occipital nerve, and in all probability depends on disease
of the spine between the first and second cervical vertebrae.’
"Another important principle enunciated by Hilton is that
'diseases of the spine may begin in the vertebrae or in the intervetebral
substance - I think upon the whole, most frequently in the intervertebral
substance, or where this is joined to the vertebra. This rather
supports the view that diseases of the spine are very often the
result of accident, because we know that in accidents, at least
so far as I have been able to discover, the most frequent lesion
or injury to the spine is a partial severance of the vertebra from
the intervertebral substance; and I suspect the same thing obtains
with respect to diseases of the spine. The pain associated with
diseased spine to which I now refer, is found upon the skin supplied
by the nerves which escape from the vertebral canal through the
intervertebral foramina close to the bones or intervertebral substances,
either of which, as I have said, may be the seat of the disease.
It is upon the recognition and right interpretation of the cause
of this pain upon the surface of the body that we ought to place
the best prospect of early and correct diagnosis in spinal disease.'
"Why does the lesion involve the juncture of the vertebra
with the intervertebral substance? Because 'the junction of a more
to a less elastic body is the weakest spot, and therefore receives
the full effect of a strain.' This illustrates how Hilton makes
use of the vital characteristics of nerve expression and tissue
vitality as the basis of diagnosing diseases. Numberless other instances
may be gleaned from the work on 'Rest and Pain.' For example, in
a case of severe abdominal pain, increasing in the erect posture,
on both sides just above the pit of the stomach, Hilton, in 1851,
found 'disease with slight displacement, between the sixth and seventh
dorsal vertebroa, and pressure upon the vertebra produced the pain
"Dr. Martyn, in the British Medical Journal for 1864, explains
why dorsointercostal pain is limited almost entirely to the sixth,
seventh, and eighth intercostal spaces on the left side. 'The aortic
arch impinges on the left side of the third dorsal vertebra, and
opposite the fourth, fifth, and sixth it receives contributions
to its plexus from the corresponding ganglia of the sympathetic,
while its plexus again contributes to the heart. These sympathetic
ganglia have, however, just received branches from the intercostal
nerves themselves; and so it is that the heart and the intercostal
spaces (fourth, fifth, and sixth) are supplied by the same nerves.
Now the fourth, fifth, and sixth intercostal nerves are those which
give off large lateral cutaneous branches, descending over two ribs
before they terminate in the skin over the sixth, seventh, and eighth
"Along this line, Dr. Embleton, in a paper published in 1870,
presented to the British Medical Association, explains the shoulder
tip pain, on the basis of its origin in the pneumogastric filaments
which enter the hepatic plexuses, 'and that then by the intimate
connection between the vagus and the spinal accessory it is expressed
in the branches of the latter which supply the trapezius and which
communicate beneath it with the third and fourth cervical nerves.
Its ordinary seat is not in the clavicle, but in the edge of the
trapezius rather than in the clavicle; and the trunks of the vagus
and the outer division of the spinal accessory, as far as they are
amenable to examination, are abnormally sensitive to pressure."'
The following quotation is from an article on "Brain-fag,
and Its Effects on Health," by John Knott, M. A., M. D. (Univ.
Dub.; M. R. C. P. I.; M. R. I. A., Dublin), in the New York Medical
Journal and Philadelphia Medical Journal, November 2.1, 1903. It
confirms the osteopathic theory, but the application made by Osteopathy
in the curing of diseases does not receive a hint.
"A fairly accurate knowledge of the structure and functions
of the central nervous system has been attained only within a very
recent period indeed. It is now well known that the human body,
as in the case of other animals, is essentially formed of a series
of minute conducting threads, called 'nerves,' each of which is
connected at one end with one of the fundamental cells of which
the various tissues are built up; and, at the other, with a nerve
cell, which regulates all the functions of the latter. The rest
is merely padding and protective covering - the 'leather or prunello'
of the complete organic structure. The nutrition of these physiological
units is supplied from the blood, minute tubular vessels containing
which ramify everywhere among those threads and cells of the body.
The blood-vessels are themselves supplied by absorption, from the
products of digestion within the alimentary canal; and the nutrient
contents pass out, by a process of leakage, to the various tissues
in their neighborhood. How the latter select their own pabulum from
the constituents of the blood, and so skillfully repair the waste
which continually goes on during the existence of life, is explainable
only by the influence of a vital force - a power of organic life,
the heart of whose mystery has not yet been plucked out by the scientific
physiologist. It is, however, well known that the amount of blood
supplied to the tissues, and the peculiar selective power of the
latter, by which they regulate their own nutrition, are both directly
governed by the central nervous system. Accordingly, when the influence
of the latter has been completely cut off from any portion of the
living body, nutrition entirely fails, and local death is the result.
When the demonstration of this connection has once been satisfactorily
understood, it will be seen to follow, as a corollary, that if the
nervous system is not in a condition to perform its usual functions
the nutrition - i.e., the health of the
whole body must suffer."
Authorities not only warrant the claims of Osteopathy, but unconsciously
in many cases, answer the ill-advised criticism against the system.
"By their own mouths shall they be convicted" C. P. McConnell,
M. D., D. O., in an article describing the spinal column, which
appeared in the Journal of Osteopathy, December, 1903, cites several
standard authorities. The quotations and comments on them are so
apt that they are given below in full:
"'The spinal cord is suspended within the spinal canal in
subarachnoid fluid, which entirely insulates it, and, meantime,
surrounded by this liquid, and insulated by it, the spinal cord
itself is out of reach of any blood-supply, except such as can come
to it from the brain above, or else along the nerve-roots at the
sides. And, in fact, the supply of this important part becomes,
if I may so speak, one of nature's difficulties. Let us see how
the difficulty is met. The blood-supply to the spinal cord is carried
out by slender [word(s) missing in original]. There are three of
these arteries, one on the front and two on the vessels which come
from the vertebral arteries within the cranium, back of the cord;
they are very slender, and yet have to run along its whole length.
No arteries so small as these run so great a length elsewhere in
the body, and pressure falls rapidly in minute arteries as the length
of pipe increases, so that it becomes necessary to reinforce these
slender vessels whenever possible, and advantage is taken of the
nerve-roots to send up little reinforcing arteries along these.
When you approach the tip of the cord the supply from below becomes
exceedingly precarious, and even apt to fail entirely because upon
the long strands of the cauda equinia the small arteries are too
narrow and too long to reinforce the cord with certainty.
"Hence we see that the tip of the spinal cord, corresponding
to the lower limbs and sphincters, is much more weakly organized
as to its circulation than all the upper parts of the cord. I believe
it is by impediment to the exceedingly and peculiarly difficult
blood-supply of the caudal end of the spinal cord that all these
various conditions lead to paralytic weakness of the lower limbs,
and they are to be met by conditions improving the circulation,
if possible." - Croonian Lectures, quoted in Clevenger on 'Spinal
Concussions,' page 195.
"The foregoing is certainly an interesting quotation and shows
logically and conclusively the efficiency of osteopathic treatment
on the spinal cord. If Osteopathy is anything it is a common sense
rational treatment, Those who desire the study of the physiology
of the blood-supply farther and, also, some more of the detailed
osteopathic theory, I must refer to osteopathic works and Schaffer's
'Physiology,' Volume II. I would like very must to go more in detail,
but my article is already getting lengthy. The student will find
some exceedingly interesting material in the references.
"'What has happened, when a man has fallen with his back upon
the ground? It is possible that the spinal marrow, obeying the law
of gravitation, may, as the body fails, precipitate itself in the
same direction, fall back toward the arches of the vertebrae, and
be itself concussed in that way. Or the little filaments of the
sensitive and motor nerves, which are delicately attached to the
spinal marrow, may, for a moment, be put in a state of extreme tension,
because, as they pass through the intervertebral foramina, they
are fixed there by dura mater; and, if the spinal marrow be dragged
from them the intermediate parts must necessarily be put upon the
stretch, producing at the same time the 'pins and needles' sensation,
and also explaining the symptoms felt on the following day. It is
impossible hat these symptoms could be the result of anything but
some structural disturbance; and they are, to my mind, the evidence
of decided injury to the nerves or marrow, although what that injury
may be is not ascertainable.'
"The foregoing quotation is from Hilton's 'Rest and Pain.'
Clevenger comments upon it as follows:
"'These views of Hilton's are capable of, extension to wrenches,
etc., of the vertebre, not only disturbing the precarious circulation
of the cord, but by strains inducing more or less permanent irritation
of the nerve-roots and meninges, and, what seems to have been wholly
lost sight of by all writers, lesions of the soft and poorly protected
spinal sympathetic communicating fibers.'
"Is not this hitting pretty close to osteopathic ideas? But
alas! They forget their application of practical anatomy when it
comes to treatment.
"Relative to the sympathetic nerve importance I must refer
the reader to another work besides Clevenger, Fox - "Influence
of Sympathetic on Disease." I am sorry space and time forbids
further extracts on the sympathetic nerve in relation to spinal
"Another writer – Moullin - 'Sprains - Their Consequences
and Treatment,' 1891, page 152, among many fine ideas has the following
to say relative to sprains of the back and neck:
"One of the most singular features in connection with these
sprains is the way in which the backbone itself, and the muscular
and ligamentous structures around it, are overlooked and ignored.
Even in the ordinary accidents of every day life there is a great
tendency to lay everything that is serious and lasting to the credit
of the spinal cord. In railway cases there is no hesitation at all;
if any serious result ensues, it must be the consequence of damage
this structure has sustained, or of inflammation following it. Little
or no attention is paid to anything else. Yet it is difficult to
see why the other structures should enjoy immunity. The vertebral
column may be strained, especially in the cervical and lumbar regions;
the ligaments torn or stretched; the nerves bruised or crushed;
the smaller joints between the segments twisted and wrenched; the
muscles detached from their bed and torn across, or thrown into
such a state of cramp that they become rigid and unable to act with
freedom; or the fibrous sheath which contains them and helps to
secure the bones laid open and filled with blood. Results, in short,
of the most serious description are not uncommon, and often leave
lasting evidence of their existence behind, when the spinal cord
"The foregoing was written some fifteen years or so ago by
an English surgeon, and what good did it do the medical profession?
Even the surgeon that wrote it did not know how to meet the conditions
rationally. It has remained for Dr. Still to give to the world a
logical system of therapeutics. The M. D.'s have been running after
false therapeutic gods. When occasionally they found one of the
converging paths they immediately lost its significance and got
into a diverging road. I can not resist the temptation to give just
one more short quotation from an old book, Page, 'Railway Injuries;
with Special Reference to Those of the Back and Nervous System,'
1892, page 29, that is apropos of our article:
"'While then the victims of railway collision [the author
is treating of railway injuries in particular, but other injuries
bear the same features] are not by any means exempted from liability
to suffer from any and every form of lesion of the spinal cord and
its membranous coverings, accumulated experience leaves no longer
any doubt that these grave results are most uncommon, and that though
the back is especially prone to suffer injury in this form of accident,
it is the extra spinal structures which, in ninety-nine cases out
of a hundred, bear the brunt of the violence and suffer from it.'
"The question naturally arises, why was not Osteopathy discovered
before? This can only be answered by the question, why have nearly
all the great advances in surgery been discovered in the past decade
or two? Simply ignorance and superstition. Hence, it is seen there
is plenty of detached and fragmentary evidence bearing upon our
interpretation of spinal injuries and mat-alignment; although not
one authority prior to Dr. Still even suggested the osteopathic
method of cure or relief of these spinal disorders, let alone their
application to diseases in general."
We often find writers in medical journals advancing old ideas with
all the eclat of a discoverer. Below is given a quotation from a
very good article in Medical News, March 18, 1906, by John P. Arnold,
M. D., by way of illustration. It is osteopathic as far as it goes,
but he fails to give expression to the fundamental osteopathic idea.
Judging from the way his school has denounced osteopaths for accepting
such ideas, we might expect a tirade of abuse to be hurled against
the author; but as it comes through the good old channels, we may
look for many of them to accept what he says and go right on giving
drugs to correct those defective backs. It is a good beginning,
and it is a pity that every M. D. in the United States cannot read
the article, and follow it by the study of scores of other facts
just as essential to the osteopath. Let them get back to the primary
conditions and their causes. Then they will be prepared to grasp
the idea of the osteopathic treatment. Dr. Arnold dwells upon the
importance of the vasomotor cells, all of which is very good, but
which is so old to the osteopath that he wonders how the importance
of this knowledge has been "almost entirely neglected"
by the medical profession so long. Among other good things, Dr.
"In the physical examination of patients one very important
part of the body is almost entirely neglected, and in general diagnosis
this neglected part of the body is one of the most important to
be examined, namely, the back.
"In every case of disease, whether acute or chronic, marked
indications will be found by a careful examination of the spine
in the region supplied by the posterior primary divisions of the
spinal nerves corresponding to those segments of the spinal cord
from which the affected parts derive their innervation. No part
of the body can be functionally or structurally diseased without
there being a disturbance either primarily or secondarily in those
segments of the cord from which the part receives its nerve supply,
and these diseased conditions invariably express themselves by indications
which can be readily detected along the spinal column by a careful
"The question will be immediately asked by the readers of
this paper as to what physical signs may be elicited which indicate
these conditions? In the first place, I may state that there are
so few people in perfect health that it is seldom that one sees
a perfectly symmetrical back. There are few people who are not compelled
at some time during their lives to seek the advice of a physician,
and in all of those cases in which the individual struggles through
life with some crippled organ, there will be found expressions of
distinct impairment of the nervous mechanism of the parts involved
which are invariably indicated by a careful examination of the back.
In all of the cases of chronic disease which have come under my
observation there have been disturbances of the nervous mechanism
of the disordered part, usually dependent upon a deficient tonus
of its blood vessels, which is the result of a deficient blood supply
to the segments of the spinal cord from which the vasomotor nerves
The same Dr. John P. Arnold quoted above has an article in the
New York Medical Journal and Philadelphia Medical Journal, May 13,
1905, in which he shows the futility of drug medication and the
imperfect knowledge at present of living protoplasm. But he thinks
he has made some wonderful discoveries, all of which were applied
by Dr. Still about forty years ago. It will be observed, however,
that Dr. Arnold says nothing about the real causes of the spinal
conditions as demonstrated by Osteopathy; and, of course, he does
not make use of the fundamental osteopathic procedures in correcting
the derangements which are the primary causes of the conditions.
In short, inhibition and stimulation, the old drug ideas in a greatly
improved form, seem to be his only methods. Here are three quotations:
"I found that pressure upon the occipital nerves produced
a certain amount of cerebral anemia."
"We find that pressure along the spinal column and in certain
regions of the neck does produce distinct changes in the circulation
in the central nervous system."
"We find that internal conditions, no matter what they may
be, manifest themselves by certain distinct signs that may be observed
by the proper, examination of the back. For instance, I have not
seen any case of dyspepsia, no matter of what type, in which there
was not distinct evidences in the mid-dorsal region of a disturbance
of the nervous mechanism controlling the stomach, and here we have
to realize the fact that we have not only a nervous mechanism to
the blood vessels of the stomach, but one controlling in part the
musculature of the walls of the stomach itself. If we examine a
case of asthma we will find the disturbance in the upper dorsal
region between the third and the seventh, and so on throughout the
whole list of diseases."
CONTRAST OF METHODS.
The facts set forth in the above quotations, and many others, were
discovered independently by Dr. Still and have been in constant
use by osteopaths in diagnosing diseases ever since the advent of
Osteopathy. Contrast their methods with that of other schools which
rely almost wholly upon symptoms distant from the seat of the real
cause of the trouble, except in a few isolated cases, such as those
Dr. Still does not consider the M. D.'s methods of diagnosis of
much value when it comes to treating the disease. He has but little
respect for the doctor that has to resort to the use of a clinical
thermometer, - a "pig tail thermometer," as he often calls
it, every time he wants to find out the conditions of the patient's
temperature. In his characteristic manner he makes the following
statement as to the methods of examination and diagnosis by medical
doctors. He resorts to a semi-military language in keeping with
his long experience in the military service of his country. The
quotation appears in The Bulletin for January, 1902:
"He has learned how to tell what his patient's temperature
is each day for a week. How much headache, limbache he has had,
how body-tired and how sore he has been. How thirsty he was; how
many times the bowels moved in twenty-four hours. How brown, red,
or furrowed the tongue has been in the first, the fifth, seventh,
ninth, and fifteenth days, but he has never been told by his school
that these symptoms are only the effects and not the cause of disease.
"'Now we have the symptoms and we will put them all in a row
and name the disease,' says the medical doctor. 'We will name it
typhoid, bilious, or some other name before we begin to treat it.
Now that we have named it we will run out our munitions of war and
pour in hot shot and shell at each symptom.' The command is given,
'throw into the enemy's camp a large shell of purgative, marked
mereurous chloride.' Then the order comes to stop that groaning
and those pains, 'fire a few shots into the arm with a hypodermic
syringe loaded with a grain of morphine,' is the next command. Then
one might add, 'look at the pigtailum oftenum and note the temperumm
till it reaches 106,' but he is given no idea of the cause of the
trouble on which to reason."
The above criticism gives an idea of what Osteopathy is not. It
may be tinged with sarcasm and saturated with ridicule, but it does
not so seriously arraign the methods of the medical doctors as the
following, taken from the Journal o f the American Medical Association
for January 4, 1902, which evidently is intended to tell what the
regular practice of medicine is as well as what it is not:
"I want to ask you seriously: Has this branch of medicine,
namely, materia medica, as far as real merit of the matter that
enters into the remedies, kept step with the rapid advancement of
other departments of the healing art? I believe I must answer this
"Now what is the use of making a diagnosis which entails so
much study and work? We auscultate, percuss, use the microscope,
analyze the blood, urine, and sputum, take cultures, test eyes,
hearing, reflexes, palpate; we explore with the X-ray, sounds, specula,
meatoscope, laryngoscope; we catheterize ureters, and, in fact,
what do we not do to a patient, - well, we finally arrive at a diagnosis.
We know what is the matter; then we begin to prescribe, and the
"As long as we use uncertain missiles, at uncertain distances,
with uncertain hope that something may do some good, I see no use
in drilling our medical recruits unless we can equip them with a
more eiact and uniform armamentarium."
We have the testimony of Dr. Frank Billings, in his inaugural address
as President of the American Medical Association, as published in
the journal of the association, May 9, 1903, that the profession
has not, with few exceptions, passed beyond the ability to name
diseases. "We hopefully look," and go on experimenting
in the good old way that has accomplished so little
"With most of us, our present methods of clinical observation
enable us to do little more than name the disease. In the vast majority
of the infectious diseases we are hopeless to apply a specific cure.
Drugs, with the exception of quinine in malaria, and mercury in
syphilis, are valueless as cures. The prevention and cure of most
of the infectious diseases is a problem which scientific medicine
must solve. What is true of the infectious diseases is also true
of the afflictions of mankind due to chemical influences within
the body. We know but little of diabetes, of the primary blood diseases,
or of the various degenerative processes of age and disease. We
hopefully look to chemistry to reveal to us the cause of these and
other conditions. Experimental medicine must be the means of removing
the ignorance which still embraces so many of the maladies which
On the other hand, the osteopath examines his patient in an entirely
different way. His mind is fixed upon finding the cause, yet he
does not overlook the symptoms. When he has found the cause he goes
to work directly and specifically to remove it, knowing that the
symptoms will disappear when the cause is removed. All his treatment
has a direct physical relation to the primary cause of the disease.
It is all determined by the actual physical condition of the patient.
There is no guesswork, no experimenting; no "cut and try"
method. It is as direct and specific as the work of any surgeon.
The osteopath does not "use uncertain missiles, at uncertain
distances, with uncertain hope, that something may do some good."
Probably no clearer statement of the difference between osteopathic
and medical practice has been made than the following by Dr. C.
M. T. Hulett:
"Every application, appliance, method or procedure used in
the treatment of disease may be classified under one of two heads.
If its effect is to modify the vital processes themselves, it is
If its effect is to remove conditions which are interfering with
those processes, it is osteopathic. Among the first are most drugs
used for their physiologic effect, much surgery, electricity, hot
air, vibrators, and similar devices. Among the second are manipulations
- the removal of lesion, legitimate surgery, antiseptics, germicides,
regulation of diet, habits, and life environment. If the X-ray or
Finsen light will kill the lupus or cancer germ, the principle of
their action is osteopathic"
THE SCOPE OF OSTEOPATHY.
Osteopathy is often severely criticized by its opponents for presuming
to be a system for the treatment of all ailments of the human body.
The criticism will apply with equal or greater force to every other
system. No intelligent osteopath will claim to cure all kinds of
disease nor indeed all cases of any one kind. Destruction or impairment
of tissue may become so great as to be beyond all hope of restitution.
While such cases are hopeless so far as a cure is concerned, it
is no more reprehensible for an osteopath, than for any other doctor,
to minister to them. The sick in any stage are entitled to the best
services available, and if Osteopathy will give relief as nothing
else will when the shadows of death lengthen, it is worthy of all
commendation. It has already established the fact that it is able
to handle successfully practically all diseases that yield to other
methods; and the complete restoration of health to hundreds who
sought for it in vain through other systems ought to inspire confidence
Upon what basis of fact, the reader may ask, is an osteopath justified
in making so strong a claim for his science? The reply is at hand.
It is not necessary for him to resort to mysticism, to distort facts,
or to manufacture testimony to establish his points. Most of the
facts necessary are already fixed by the labors of anatomists, physiologists,
and pathologists. Those facts briefly stated are these:
(1). Each and every part of the body has its proper place, form,
structure and function, and all are so combined as to form a perfectly
working machine capable of self-regulation and self-repair.
(2). Each part of the body is provided with nutrition carried to
it in the circulating fluids, and all waste, except from surfaces,
is carried away from each part by the same means.
(3). Every part of the body is supplied with nerves which control
all its functions, such as motion, sensation, circulation of blood,
growth of tissues, secretion, and heat generation and regulation.
Impairment or destruction of any of these nerves results in. the
disturbed, or destroyed, function of the part supplied by them.
(4). Every part of the body will do its duty if it has a chance.
That is what it is for and it is a contradiction of thought to say
that it will not. This is an axiom, the denial of which involves
the denial of both health and disease; it would even mean the denial
of the existence of the human body as we know it.
(5). Air, water, and food are the only elements necessary to be
put into the body in order to maintain and restore health. The fact
that millions have lived healthy lives without anything else is
proof that substances foreign to the body are not necessary to its
well being. Their presence means discord.
The original osteopathic theory has never been abandoned. No application
of osteopathic principles has ever been found useless. No treatment
has ever been given by a genuine osteopath without the minimum of
injury and the maximum of good to the patient. The osteopath does
not experiment with ear, eye, nose, teeth, throat, bronchial, lung,
heart, stomach, liver, spleen, pancreatic, intestinal, kidney, bladder,
uterine, ovarian, and skin troubles. The treatment of nervous and
mental ailments is not an experiment with an osteopath. He seeks
the causes of all troubles, removes them, and gives nature a chance
to demonstrate its curative power. It is true, that every osteopath
may come across cases that puzzle him, Even then he does not resort
to the "cut and try" methods of other schools. Knowing
as he does the sources of vitality to the part affected, he can
stimulate to greater activity or quiet excessive activity and thus
accomplish results impossible by any other means.
THE OSTEOPATH'S WORK.
What then does the osteopath do ? He simply removes the cause of
the trouble if in the physical organism. If there is literally a
thorn in the flesh, he removes it. If there is a dead tooth that
is giving trouble, he will advise the patient to consult a dentist.
If it is a piece of steel imbedded in the substance of the eyeball,
he will, unless he has made a specialty of surgery of the eye, recommend
an oculist. If he finds an infernal tumor that endangers health
or life, and the knife is to be used, he will advise that a surgeon,
skilled in that special work, be called upon to remove it. In all
these things he does just as all physicians of all schools do. These
are cases calling for the -removal of a foreign substance or of
parts that are practically dead and have virtually become a foreign
substance so far as their surroundings are concerned. Experience
and common sense generally dictate that the offending substance
should be removed. But such cases as those mentioned comprise a
very small proportion of all the cases a physician is called upon
The volume of the work of the physician is in the prevention of
disease and in the restoration of health to any and every part of
the body. Here is where the osteopath excels, to the surprise of
those who are not grounded in the essential principles of the science.
He succeeds because he applies the same principle he applied when
he removed a thorn that was giving trouble. He goes directly to
the cause, removes it, and thus gets rid of the obstacle to health
of the part. He knows that if a part is not doing its duty there
is a cause for it. That cause may be a foreign substance, or a malposition,
interfering with the free flow of fluids or the transmission of
nerve force, thus interfering first with function and second with
structure. He proceeds at once to remove the cause of the trouble,
and in doing that sets free all the forces of the body involved
in combating disease and maintaining health.
The prevalent theory of so many doctors that most diseases are
due to germs, may be believed. What can the osteopath do to kill
them? Surely he must use a germicide. True, he may use an antiseptic,
or possibly only soap and water, to remove dead matter and its accompaniments
when within reach. But what about those germs that are in the blood,
in the walls of the intestines, in the liver, in the kidneys, in
the lungs, in the spinal cord and brain? Surely he will have to
administer a drug to kill them. Not at all. When you call to mind
the fact that pure blood flowing naturally is the greatest antiseptic
known for internal conditions, that no germ can live long or multiply
in it, you see what Osteopathy may do. But, you say, if the blood
is not pure it must be purified by taking some drug. What are the
spleen, the liver, the lymph glands, the lungs, etc., for if not
to make pure blood when the food is supplied from which blood is
made? Pure blood is not manufactured in an apothecary's shop. It
is made in that matchless laboratory within the human body, and
when that laboratory is in working order it will send forth a supply
of its goods perfect in quality and exact in quantity.
Let it be remembered also that germs do not thrive in live tissues,
and that every organ withinn the body as well as all other parts
are supplied with nerves that are necessary to keep them alive.
Surround the infected area with healthy tissue and the germs will
soon die for want of suitable nourishment. Thus it is evident why
Osteopathy has met with such remarkable success in the treatment
of such disease as malaria, influenza, tuberculosis, typhoid fever,
diphtheria, measles, etc., etc., which are acknowledged by all to
be determined by the presence of germs.
Furthermore, it is the nature of the organism to combat these germs.
The tissues of the body will destroy them if they have half a chance.
There are thousands of cases in which nature has done this work
successfully for every one cured by the introduction of an antitoxine.
Of course, cleanliness without and within, is the first element
in overcoming all germ diseases. Cleaning Havana stopped yellow
fever and small-pox. The medical men said cleaning up the city stopped
the yellow fever and vaccinating the people stamped out small-pox.
One medical man was so unkind as to say 'if they had vaccinated
every body for yellow fever and cleaned up the city for small-pox,
the results would have been the same.'' The story is told of General
Butler, that when he took possession of New Orleans during the Civil
War, the first thing he did was to order the Mayor to clean the
city; and, to enforce his command, told the Mayor he would hang
him if yellow fever broke out. No other effective means has ever
been found for preventing or overcoming epidemics. Internal cleanliness
is also essential, but is impossible without a perfect distribution
of nerve force, nutritious blood, a free circulation of all the
fluids of the body, and unimpeded excretion. These are the lines
along which osteopaths have proven themselves to be experts.
The question is often asked, how does an osteopath treat a patient.
It might be proper to say that he does not treat a patient at all;
he works to remove the cause of the trouble, according to the conditions
found. If your watch stops you do not inquire how the repairer is
going to treat your watch to make it run. You know he first examines
it to see what is wrong. If it is only dirty he cleans it; if the
mainspring is out of order, he fixes it; if a pinion is loose, he
tightens it; and so on with all the parts. So with the osteopath
in treating a patient. If he finds something wrong in the neck,
the back, the hip, he corrects it. If he finds something wrong with
the stomach, the heart, the brain, he searches for the cause of
the disturbance and tries to remove it. He may not succeed in some
cases any better than the jeweler succeeds in repairing every broken
or worn out watch that is brought to his shop because it does not
keep correct time; but no one would think of blaming a jeweler for
not performing a miracle.
The watch repairer uses a variety of instruments in doing his work.
None of those instruments have sensation, life. They are tools without
power in themselves. The osteopath generally uses his hands only.
They have sensation, life. They arc trained to detect, instantly,
anything wrong, and they are so skillful in movement that they can
manipulate the most delicate and sensitive parts with little or
no pain and absolutely no danger. The delicate living tissues of
the human body are too precious to be pummeled with pounding machines,
pierced with steel probes, scraped with curettes, and cut with the
scalpel in the hope of curing disease. But if a part is dead it
is the province of the surgeon to remove it, making use of the best
instruments devised for that purpose. Hence it is evident that a
correct osteopathic treatment is the correction of some abnormality
by the application of the simplest scientific principles.
What diseases then is the osteopath justified in treating confident
that in almost every case he can do as much as, or more than, any
other? Negatively, it may be said that if there is a part of the
body diseased without cause, or that is not dependent upon the free
circulation of the blood and lymph for its nutrition, or that is
not maintained in structure and in function by its nerve supply,
that part is not amenable to osteopathic treatment.
Many think, honestly, that Osteopathy is good for chronic diseases,
but cannot reach acute cases. By what principles of common sense
or by what rules of logic one can arrive at that conclusion is hard
to understand. Every one knows that the sooner a displaced or a
fractured bone is fixed, the better. Every one knows that the sooner
an antidote is given for a poison or the sooner it is removed, the
better. Every osteopath knows that it is easier to overcome an acute
attack of grip and prevent bad after effects than it is to remove
the complications so often found after the drug treatment of this
terrible malady. The same is true of other acute diseases as well
as grip. The little fire just starting is more easily extinguishedthan
the conflagration resulting from it.
It is hard to get people to understand these simple facts because
the reverse has been impressed upon their minds from infancy. They
honestly think they must "take something" for every ailment.
In order to satisfy their whims many good drug doctors give them
bread pills or colored water, and allow nature a chance to do the
curing. Let us commend them for this, if it is the best they know.
Osteopathy is better able to judge of the probability of a disease
before it makes its appearance by the usual symptoms than any ether
system. Almost any one, even a layman, may say with truth and in
absolute confidence that a certain person with a flat chest, a long
neck, sloping shoulders, projecting shoulder blades, and extreme
obliquity of the ribs is a fit subject for consumption (phthisis).
Why? Because all the conditions favorable for the development of
that disease are so evident that "he who runs may read."
The osteopath is trained to look for and recognize every possible
cause that may weaken a part so as to lay it subject to disease,
and then apply the treatment necessary to remove those causes; or
in case it is not absolutely removable make it as nearly inoperative
as possible. He does not stop with an examination of these physical
signs of weakness, but examines every part of the body, the derangement
of which could possibly be a cause for disturbance, to see whether
or not any impairment exists.
One illustration will suffice. No one, except possibly some M.
D. who wishes to bring Osteopathy into disrepute, as one once did
while inveighing against the writer in conversation with a patron,
will deny that the nerves and blood and lymph vessels of the feet
are wholly dependent for their action upon their unbroken connection
with the trunk. Now a disturbance in the foot may be due to a local
condition only, as a wound of any kind, in which case local treatment
only may be necessary. So far a D. O. would not differ from an M.
D., except that, in his treatment, he would not risk impeding the
progress of nature by unnatural applications. The osteopath would,
however, want to be sure that there was no interference between
the injured point and the sources of force and nutrition in the
trunk which supply the injured part with life and the power of regeneration.
If no local causes were apparent in the foot, the osteopath would,
naturally, conclude that the trouble lay nearer the source of the
supply of vitality to the foot and treat accordingly.
Again, suppose an osteopath were examining a man for a life insurance
company. Would he consider him a good risk if the innervation to
the kidneys was interfered with so as to invite Bright's disease;
or to the lungs so as to make pneumonia inevitable on the slightest
provocation; or to the head so as to interfere with the nerves to
the blood vessels of the brain making them liable to rupture and
produce paralysis? The osteopath does not have to wait till the
worst has happened before he can do his patient any good. In fact,
in the very beginnings of disease, long before the symptoms which
all other schools look for appear, he can give the warning and do
what no other system does by any direct means ; namely, treat where
the first cause lies so as to remove it, or at least lessen its
influence. Herein lies one of the strongest merits of Osteopathy;
one that has not been applied much yet to the spreading of health
and happiness, and to the saving of thousands from the many forms
of clearly preventable disease and suffering. Can anyone want a
Osteopathy does not injure a healthy part in treating any case
of disease. The stomach is strengthened in treating for lung troubles,
rheumatism, sciatica, etc., instead of being weakened as in the
administration of opiates or salicylates. The heart, or circulation,
is not injured in headache or any form of nervous diseases as by
the taking of a coal tar preparation or any kind of a depressant.
The well parts of the body are kept well and the diseased parts
are put in a condition to recover, if recovery is possible.
In short, Osteopathy is simply common sense. Theoretically, it
rests upon verified knowledge of the human body. Practically, it
rests upon the application of skill in recognizing and correcting
abnormalities of the human body. It has been attacked by abuse,
misrepresentation, ridicule, sneers, contumely, secret contempt;
but it has never been opposed by argument. It stands today as the
only system which requires a thorough study of the human body in
health and disease, and which is built upon unassailed and unassailable