| In order to comprehend osteopathy we must comprehend the work of Andrew Taylor Still, and to that end we must know in a clear way something of the immediate predecessors of the man, together with something of the medical world upon which the eyes of A. T. Still opened and into which they looked with the sharpest criticism of the ages. Improvement in human institutions comes about by two methods, which are in reality two aspects of one fundamental fact. These two are reform and revolution. Reform is slow, revolution rapid; but the results accomplished by both are essentially and practically the same. Fundamental and original discoveries in science are always revolutionary in their effects, as are also fundamental perceptions in art. Now medicine is an art, and when we discuss "reform" in medicine we are compelled to look at our subject from two separate and distinct points of view - namely, the changes that have come about because of discoveries in pure science which have only an incidental bearing on the practice of the art of medicine - and changes that are instituted by the actual practitioner of medicine himself apart from the discoveries of pure science. In examining the history of medicine, only one practitioner can be found who combined the two things in himself; who used pure science as his primary method and directly based his practice upon it. This man was Andrew Taylor Still, whose reform of medicine was revolutionary - therefore rapid - and radical to the very roots of the entire structure itself. MEDICINE'S SLOW PAINFUL REFORM Previously to Still, medical practitioners had honestly tried to reform their art, and suffered the fate of the reformer in consequence. The first great reformer in what we call modern medicine was Flaubert, the French physician of the latter end of the 18th and the beginning of the 19th Century. Medicine in his day was a procedure of purge, vomit, blistering, bleeding, and a mixture of materia medica drawn from nauseating substances of all kinds, and from plants, the virtues of which were based upon absolute superstition - the entire art in that day being but slightly more scientific or civilized than the practice of the savage tribe with its medicine man. Not one of the physiological beliefs of the physicians of Flaubert's time survives in the present day. Flaubert failed to make the slightest impression on the medical craft of his age. He made no appeal to science. There was no science, save anatomy, in that time with a direct bearing on medical practice. Such reform as he attempted was nothing but a protest against every one of the agents and every method of treatment then in use as therapeutic. In a word, Flaubert sought to dismantle medicine as he had found it. Small wonder he failed in a day when the art of medicine had as little true understanding of the real body as could possibly be, if we neglect the imperfect work of the anatomists of the time, of Harvey on the circulation and of Hunter on the coagulation of the blood. Flaubert had in him the same medical nihilism as Still had when he looked around and saw that "the patients we were treating for disease were dead". But in the hands of the French physician medical nihilism was futile, whereas in the hands of Still it led to the only general therapy the world has ever known. HAHNEMANN, THE SECOND REFORMER The second attempt in the modern reform of medicine by practitioners was made by Hahnemann, the founder of the homeopathic school, who, quite unlike Flaubert, was anything but a medical nihilist. Hahnemann's great principle was based on the two main beliefs, first, that drugs of any kind (or any other kind of substance) which, when introduced into the body, would produce symptoms similar to those of the disease to be cured, would effect that cure; and secondly, that the smaller the dose of the drug used the more vigorous would be the physiological (curative) effect of it. The first belief became a kind of motto with the homeopaths - "Like is cured by like." This system of therapy in its practical application was in reality the abandonment of internal medicine altogether, for in the high dilutions given all physiological effect vanished. Hahnemann succeeded, without wishing to do so, in abolishing drugs, although he believed that he was using drugs in stronger form than ever. A glance at the materia medica of the homeopaths is sufficient to produce nausea in a person with a "delicate stomach," or in other words with psychic tendency to sea sickness. HELPED BY WEAKENING THE DOSE Hahnemann not only swallowed the entire ancient apothecary's shop, but vastly multiplied the number of drugs in use by the old "regular" school. It is difficult to believe that any homeopath today can take himself seriously in the matter of "high potency" dilutions, although human credulity can stretch ad infinitum. Certainly in these days of scientific pharmacology and physiology, of pathology and immunology, one would imagine that "old time homeopathy" should be a thoroughly dead cock in the pit. Hahnemann's reform, however, was the best "practical" reform up to its own time, for it saved many a life by indirection. The medicines could literally do no harm, a fact to which Osler attributed homeopathic "cures". ECLECTICISM THE THIRD REFORM The third great reform practitioner was Bennett, the Scotchman, who reacted in the other direction. Bennett founded what he called the Eclectic School, that is, the "choosing" school. Any remedy whether homeopathic or "allopathic" (a name ever repudiated by the ancient school of physicians) that was proved good would be used by the eclectics. But Bennett was compelled to put a new shine on the old drugs, so he decided to extract the drug in a fresh rather than in a dry state, making the drug more active, as he believed - an absurdity on its face to those who know. But Bennett did better than all this. He was probably the first reformer who by his opposition compelled the old doctors to abandon the bleeding methods in general use in his time. Thus far we see that every useful reform in modern medicine was in the direction of destroying whatever therapy the art of medicine had inherited from the ages, rather than in creating or discovering a new therapy underpinned by scientific fact. A. T. STILL, M. D., BROUGHT A SCIENTIFIC THERAPY And then, on the heels of Bennett came Still, the fourth and last reformer of eminence of modern medical art, with a therapy which automatically abolished all previous practiced therapy by positive, not negative, methods of treatment. Osteopathy had been discovered. An amazing fact in the history of medicine is this, that from the time of the discovery of the valves in the veins by Fabricio ab Aquapendente (which led to the discovery of the circulation of the blood by Harvey) down to 1890 when Behring, working in Koch's Laboratory, discovered the antitoxins, not one experimental result of real science had ever been successfully applied to the cure of any disease in man or in animal! What an in stupendous fact! From Harvey to Behring scientific investigation with its infinite printed matter in our knowledge of the conduct of living matter, had resulted in positively nothing in the way of therapy! Can you wonder that osteopathy, when it came, was a success? The panorama of Europe's great scientific progress in all the biological sciences accomplished nothing except to strike down, one after another, every medical agent, every therapeutic fallacy that had come down from a past black with superstition and death, and every one that had sprung up since the Italian Renaissance. Medicine, it was seen, was only a hideous nightmare, rescued during the ages from the dismal superstitution of the jungle and the primitive imagination of the brute man, who filled the earth and the air with the deities and the devils of his childlike and fearsome brain. With these truths clearly before us we can understand the work done by Still, and can comprehend why osteopathy is! We can understand how this therapy, vital from its first conception, has remained vital and will continue to live and do its work even in spite of the fact that its practitioners and its researchers have not been able to interpret it with that detail and precision that is scientifically desirable. Still's entire therapy rests on two grand generalizations which, like all revolutionary discoveries in science, were at first totally incomprehensible to the thought of the age upon which they dawned. To measure their revolutionary character we must remember in what the medical bedictment of the art of medicine there lies in that lief of that day consisted. The cure of disease in that time was limited in the main to internal medicine. By that is meant the putting into the body - into the blood and the tissues - substances called "medicines" because they were believed to heal the body. In 1870 disease was just beginning to be studied. Virchow had just dawned with the discovery of the modern science of pathology. Until Virchow's work nobody had the slightest understanding of the nature of disease itself. Pathology was only a name. The best scientists of Europe knew as little - far less indeed - of disease than the average intelligent layman of today who reads the popular magazines. Neither scientists nor physicians had the slightest suspicion that many diseases were caused by the growth in the tissues or the blood, or in both, of the parasitic organisms so well understood today. Tumors were mere "lumps" growing in the body, some of which resembled normal tissues. Skin eruptions of every kind were believed to be "impurities" of the blood, and the people swallowed oceans of drugs believed to be "blood purifiers". Patients with fevers were generously bled even as late as 1870. At that time purging and vomiting were the usual practice. The quantities of mercury salts sold by prescription and without prescription would stagger the intelligence of today. Quinine was handled commercially by the ton as a staple to the people. It was swallowed by the ton, with and without prescription, by all persons, from babes to centenarian, in all febrile conditions. The wholesale drug trade was one of the most important divisions of civilized human activity. Drug stores were drug stores then. A little scientific pathology would have remedied these evils, but of scientific pathology there was none! Virchow was only a dim blaze on the horizon of things. Let us repeat: The theory back of the use of the drug was that some kind, or any kind of substance, taken into the body would or could work a cure. In the very midst of this dismal credulity came A. T. Still, M. D., with this message: The body itself contains within itself all the chemicals, all the medicines, necessary for the cure of disease. This assertion was, as you can see, subversive of every belief then current in medicine, but only a moment's thought is necessary to understand how true it was, and how true it is today, and how it had to be from the dawn of life in this old world. There is hardly a disease that is invariably fatal. No disease invariably kills all the individuals whom it attacks. Indeed the vast majority of human beings and animals are normally in the act of continuously "curing themselves" of disease by which they are being continuously "attacked". Were this not true all races of animals including man, would swiftly be destroyed by the various biological reactions which ignorance had named disease. The sciences of histology, pathology, immunology and pathological chemistry, in the past 30 years, have told us what disease is, and in this modern definition of disease we find that it is only a chemical reaction of one or another kind among the molecule-complexes, or atom-complexes, of which living matter consists. Thus at one swift stroke of his clear intellectual vision - A. T. Still saw the biological basis upon which modern pathology, in its histological, immunological and chemical aspects, has been reared since the appearance of Virchow and Pasteur. Credit for this original and far-reaching perception - the perception of a mind of prime origination and imperial power - will be given to Still in due time by the future historians of our sciences. The earlier pupils of Still could see the force of the truth he taught them, because they themselves had been born and bred in the midst of the medical ideas of Still's own age. And these early pupils will recall how bitterly this fundamental truth was fought, how viciously it was ridiculed by the medical men of that time and later. Today this fact is taught in every university in the world as one of the fundamental bases of a superior and scientific medical education. TRUTH USUALLY OBVIOUS AFTER BEING PROCLAIMED One of the great arms of Still's new system of therapy was therefore the principle of the general immunity of the blood and the tissue to disease, and so self-evident is the truth of this principle that the wonder is it was not seen ages before the time of Still and his pupils. Why do the sick recover? Answer, because the body is self-healing. Why is the body self-healing? Answer, because only those organisms that had in them the necessary chemical and structural elements for resistance to so-called disease survived in the struggle for existence during the long and tragic life-history of the past. Because only those organisms that had these necessary elements of resistance and recovery from disease, could live long enough to reproduce their kind, thus passing down to the new generation the self-healing and self-adjusting mechanisms that safeguard the maintenance of the races we see inhabiting the earth today. But if this is true, why is there any disease today in men and animals? Why are not the surviving races entirely free from disease? Answer, because for the survival of a race it was essential only that the self-healing mechanisms would enable a few of the race to live long enough to reproduce its kind. Absolute immunity to all diseases in all organisms was not a condition of survival. But it is clear that if immunity in some or in a few were not general against all death-dealing diseases, there could have been no recovery of any organism whatsoever, and hence there had been no survival, whatsoever, and life had ceased long ago. ALL LATE RESEARCH SUPPORTS STILL'S THEORIES Still clearly perceived the necessity of general immunity against all diseases, including the tumors, but he did not derive his principle from the agreement above outlined, because in his day the facts of development as discovered by Darwin and Wallace were mainly unknown to the world at large, and not understood at all or accepted by the great body of scientific men who, on the contrary, ridiculed the law of natural selection as an altogether too simple thing to account for the facts of life. If today that law is universally taught as a fact, it is only because it was a discovery of prime character. And if Still's great principle has been proved to be absolutely true by the world's researches of the past 25 years, it is only because it was true when he announced it, and hence destined to be proved experimentally some day, soon or late. In short, his principle had to be tested by the fire of experimental science and experimental criticism, and how well it has come through untouched in any phase of its integrity by these tests, it has been my privilege and my happiness to study and to know. RESULTS PROVE OSTEOPATHY SUCCESSFUL AS A THERAPY But Sill's principle has been passing through another and a different kind of criticism and test during the years that have followed its announcement. I mean it has been tested by the practical experience of the pupils of Still's school in the actual treatment of disease. Osteopaths love to point to their results, past and present, as the living proof of the truth of Still's theory in its twofold form. For Still, studying anatomy, had the rare power of perception to see that the backbone is the keystone of the body, and that this imperial palace of the imperial tissue of the body - the nerve - was the source of constant disturbance of the circulation of the blood. The nerves as well as all the other tissues of the body, live in an ocean of blood (or lymph, that comes from the blood) and the back-bone through its innumerable slips and mal-adjustments does and must produce innumerable disturbances of circulation. Hence the second arm of Still's theory - the osteopathic lesion. Accepting this theory from the mind of Still, osteopaths worked whole heartedly with it as their main if not the only tool of healing, with what results the whole world knows. I sometimes think that the spirit of Andrew Taylor Still will return upon many osteopaths who have lost faith in that old back-bone lesion as the main causative factor in disease, and will annihilate their skepticism. These modern skeptics, these doubters of the truth of Still's back-bone lesion theory of disease, live and grow prosperous on that theory while they doubt the truth of it in their hearts. OSTEOPATHY FOUNDED UPON BACKBONE LESION ADJUSTMENT Let such doubters and skeptics remember that the earlier osteopaths succeeded in winning the faith of the public in osteopathy only because they preached that back-bone lesion day and night. Let them remember that if it were not for that imperial generalization of A. T. Sill, there would be no osteopathy today. Let them remember that every patient they treat, they must treat by the backbone method, or lose that patient. Let them remember that every new patient that comes to osteopathy for treatment expects that treatment in the main. (I am not now speaking of sprained ankles, broken noses, or obvious traumatisms in parts other than the spine. I am speaking of disease in general.) What treatment have you, gentlemen, for diseases in general other than spinal treatment based on Still's lesion? And if you point to the glorious record of osteopathy, do you not point to the osteopathic spinal bony-tissue lesion as the cause of that record? And if you win your share of success by treating the spine are you not at least an unintelligent operator (if not a selfstultifier) when you repudiate the great secondary principle of which osteopathy consists? Are you waiting until the scientists of the world have put their experimental approval also on this back-bone etiology? Are you waiting until, through the dictum of the world's men of science, the whole medical profession have adopted the back-bone lesion as the main causative factor in disease, and have taken over your therapy to themselves - are you waiting for this until you become real osteopaths, osteopaths in mind as well as in fingers? If you are, you can rest assured that you will not have long to wait. We are living in an age of revolution, and Still's medical revolution is at the world's door today. But again, science itself is not without the evidence that the spinal lesion is the main factor in the causation of disease. And this evidence is quite as axiomatic in the matter of Still's spinal lesion as it is in the matter of Still's law of general immunity. I§ it necessary to bring forward scientific evidence that spinal etiology is true? Is it necessary to do this to convince the osteopath? Any osteopath? If so, what has such an osteopath been doing? What becomes of the entire osteopathic therapy? I will tell you what becomes of it. It vanishes like the dream of a fool into that limbo of hideous dreams on the other side of the moon! The world would be well rid of it, and the thousands of men, women, and children who have been cured by it have been victims of a moonshine psychology. ZOOLOGY WILL SUPPORT THE LESION THEORY Our grand old man in his life-time was disturbed by no such fears, and science is as able to demonstrate the truth of the second great principle he discovered as it has been to demonstrate the truth of the first. The osteopathic lesion as a general factor in the etiology of disease is grounded on the same scientific basis as is Still's theory of general immunity to disease, and is destined surely to be accepted, in the end, by specialists in zoology and hence in the facts of natural selection - the great and fundamental law of life and of matter itself; next by the specialists in pathology, a science that is utterly incomprehensible unless studied and interpreted in the light of that great law of natural selection; and lastly by the medical profession itself, the individual members of which are trained by these specialists in the fundamental sciences pertaining to the structures and the work of the animal body. But before Still's spinal lesion can be accepted by the medical profession as the main causative factor in disease - a cause that interferes with the so-called "normal" conduct of the body - that spinal lesion in all its significance must be studied by the zoologists, the physiologists, the physiological chemists, the pharmacologists, and the pathologists of all kinds, and its importance in the life history of races mastered and understood. THERE IS NO OTHER GENERAL THERAPY TODAY! There is no general therapy today, there never has been a general therapy, excepting osteopathy, based on these two great generalizations of Andrew Taylor Still - the law of the general immunity of organisms to so-called disease, and the law of the spinal lesion as the main ultimate etiological factor in that great tribe of animals called the vertebrates. But you may say, how about the vast hordes of animals that are not vertebrates, that have no backbones? Are they to be without a therapy? Did not Still think of them, too, in his grand scheme of healing? The answer is simple. He did not. Still had in his hands only a man. But you will observe that the invertebrates, plants as well as animals, are in perfect harmony with the law of general immunity which Still announced for the human species. A. T. Still was not a "materialistic" thinker. He believed, as was natural in his day, in a land of "divine" supervision of nature, or perhaps in the divinity of nature itself - a belief or conviction to which many men of advanced science are coming back today, and so forward has become the scientific mind that a Thomson, a Ramsey, a Becquerel and a Still could meet on common ground and understand one another's philosophical conceptions of nature and the "soul" of nature. The very fact that Still in his science of disease and its remedy did not take into account the invertebrate world, and calculated chiefly if not wholly the human element, lends additional value to his discoveries. Science has demonstrated his law of immunity in all living things, as well as in man. If what he held of man be true, it must be true for all other forms of life. Were it not true for all other forms, it could not be true for man. The very test of its truth in the case of man was its universal application to all living things. And in the past 25 years it has been proved universally true by the laboratories of Europe. His theory concerning the spinal lesion as the main primary causative factor in disease must stand a similar test. It must be true not only in the case of man, but also in that of all other vertebrates. And he who adequately studies comparative pathology in the light of the law of natural selection will not for one minute combat the theory of the spinal lesion in that etiological sense because he perceives the necessity of its truth. To these osteopaths who have doubts as to the virtue of that theory as a primary conception in their art, I would recommend a careful study of the literature of evolution and comparative embryology and can guarantee them that their convictions will then square with their practice. This original theory of A. T. Still has been steadfastly taught to the young osteopaths that have been trained in the American School of Osteopathy at Kirksville. It has been instilled in their minds at that school from the beginning. It has been consistently taught them during the years I have been myself a teacher in that school, and when it ceases to be taught there the American School of Osteopathy will be no longer a representative of the essential and fundamental thought of its founder. No school that does not make that theory the main spring and purpose of its existence can be called osteopathic without false pretense and the moral and scientific obliquity that false pretense of any kind implies. And when osteopathy lets go of that primary teaching it ceases to be. |