Dr. A. T. Still Founder of Osteopathy
M. A. Lane
The key to the work of Andrew Taylor Still in his capacity as a scientific reformer was his unusually and powerfully original mind. Like all men of surpassing genius his one great dominant characteristic was his strong and active originality. He was by nature entirely unfitted to follow in beaten paths those who had gone before him. To strike out in new directions, to carve for himself with his own hammer and chisel the block of knowledge, theory and practice, was for him a necessity; and few of the many theories he held were borrowed from or suggested by his predecessors in the art of medicine. He appeared on the stage of medicine when that art was just on the verge of the searching and universal scientific reforms that were destined soon to change the entire point of view with which men, up to that time, had been accustomed to regard their own bodies in health and disease. But in his earlier days established medical practice was almost as barbaric and ancient as it had ever been since the age of the great Greek school of physicians in the time of Pericles, five hundred years before Christ.

When Dr. Still was a young man, speculating on the cause of cholera, many of the great scientific discoveries and epoch-making inventions in the art of medicine were just in the making, or were being one by one announced to an astonished and unbelieving world. That was the day when Europe was yet ringing with the freshly announced discoveries of Theodor Schwann, who was the first to see and announce the fact that the bodies of all animals were built up of cells - the so-called "Cell Theory" of Schwann, a theory which, like Ehrlich's theory of immunity, soon passed into the realm of undisputed fact. That was the day when the new pathology - the cellular pathology-was germinating in the mind of the great Virchow, who has been rightly called "the father of pathology"; when the powerful Louis Pasteur was doing his best thinking in the remarkable controversies concerning life and its origin that were then raging in Europe, with Liebig on the one side and Pasteur on the other; when Helmholtz was forging in his mathematical workshop the law of the conservation of energy, and reducing to demonstrable fact the conception that living bodies were chemical and physical machines in which energy was transformed but never lost; when Johannes Mueller, the father of modern physiology, at the very apex of his career, was about to pass away; when the term "irritability of living matter" was refreshingly and startlingly new; when the chemists of Germany and France were discovering the marvelous facts of organic compounds, and searching by synthesis and analysis into the secrets of living nature; when the theory of "vital force" was rapidly disappearing out of the minds of scientific thinkers; when Darwin was forging the links of his great chain of natural selection; when von Baer was first perceiving the amazing facts and their laws of the new-born science of embryology; when Haeckel was observing (for the first time) the fact that the white cells of the blood had the power of ingesting small particles of dead matter-the first perception of the "phagocytosis" of Metchnikoff ; when Claude Bernard, the French physiologist, was announcing his theory that all substances that could enter the body were to be regarded as either foods or poisons; when pepsin was being discovered by Schwann, and the structure of the kidney by Henle; when, in one word, the whole scientific world was in a state of ferment, in which wholly new views and facts about living matter were being upturned and established every day, and the old foundations on which medicine had been resting for ages were being rapidly and surely dissolved away. It was in such an age that A. T. Still appeared.

When Dr. Still was beginning to see clearly through his newly formed ideas of therapy and the causes of diseases in general, the science of modern pathology was in its infancy, and the science of bacteriology, as we know it today, was as yet virtually undreamed of ; the science of physiology was only just beginning to show its first and broadest outlines; and the sciences of histology and embryology were only beginning to be understood in their more startling details; and we can say with absolute truth that Dr. Still was the only man in America who could in any way whatever be regarded as being abreast with the spirit of Europe; rather let us say he was, in many of his primary conceptions, forty years ahead of Europe and his age, a fact which we will try to show here, and a fact which will be amply recognized in the history of medicine as it will be written in the time to come.
To appreciate Dr. Still's true inherent greatness, it is necessary to roll back the years, to reverse history, and to realize to ourselves the medical doctor of that early day, especially in the United States. Dr. Still's earlier life say until he was 50 years old - was lived in a time when medicine in America had cut itself entirely adrift from the medical education of Europe. In the earlier years of the nineteenth century the American physician was always educated in Europe, and in those primitive times, reaching back into the later years of the eighteenth century, some of the most famous anatomists of Europe paid now and then visits to these shores. In Philadelphia there still stands, or stood until recently, an anatomical theatre, where anatomists exhibited and lectured to the lay public on handsome dissections of the human body, as had been the custom in Europe. Those were the times when no medical schools existed in America, and all American physicians were educated abroad. With the rise of the first medical colleges in America, however, this custom ceased, and toward the middle of the last century, America was educating her own doctors, who, in the beginning, were almost as well informed as their European colleagues. But this equality of education soon passed away, and from then onwards medical education in America was distinctly inferior to that of Europe. The American medical colleges passed into the hands of American doctors who had themselves never studied in Europe, and the result was that hundreds of medical schools of inferior type sprang up in this country, and American medicine was now upon an American basis, and a basis much lower, of course, than that of the great universities of Europe, where the newer medical sciences were being born and developed. Hence there was in America scarcely a handful of physicians of a high scientific type. There were no discoveries made in America, and such medicine as was here was of the distinctly old style, crude and backward, and loaded with many of the superstitious beliefs and practices that had marked the medicine of Europe before the days of Schwann and Pasteur, of von Baer and Raymond, of Virchow and Helmholtz, of Bowman and Henle, of Mueller and Bernard and of the other pure scientists whose work did so much to place medicine on a pedestal higher than that of mere experience or empiricism. American doctors were notably behind the procession of Europe, and only here and there could be found a doctor with any appreciation at all of the medical reforms that were going forward so rapidly in the universities on the other side of the sea. To this rule, surgery was something of an exception. American surgery was always good, but surgery is a thing distinctly apart from medicine, and in so far as the doctor was a surgeon he was not a physician at all.
Such was the state of medicine in America when Dr. Still appeared, with entirely new conceptions and theories concerning diseases, their causes and cures. In the west of the United States, far remote from the slightest influence of Europe, in the midst of the black ignorance and incompetence of American uneducated doctors, grew up this singular reformer, who, had he risen in Europe, would have exerted the most powerful world-wide influence from the very first.


Like all great original thinkers, Dr. Still had theories for almost every disease and function of the body, and many of these theories were crude and incompetent, just because the then state of the sciences he dealt with was still crude and incompetent. In fact, when Dr. Still worked out many of his theories of disease, the real causes of these diseases were wholly unknown and seemingly incomprehensible. But of the various theories which, like sparks from a grinding wheel, flew off from his original and ever-active mind, at least two were of prime order and absolutely true and good. These were first, his theory of the mechanical (anatomical) lesion, and secondly, his theory of the chemical immunity of the body, both of which he put forth as the cause of disease, and both of which have absolutely stood the test of time and subsequent scientific criticism and experiment. The scientific historian of the future, who will write at a time when all prejudices of professional jealousy and hate will have been lost in the great historical perspective, will probably regard Dr. Still's greatest contribution to science as being his theory of immunity rather than his wonderful perception of the mechanical origin of so-called disease. For it is a fact that while the great conception of the osteopathic lesion was directly responsible for the grand dramatic debut of osteopathy and its seemingly miraculous cures, more recent knowledge and understanding of osteopathic treatment and its results have called attention in a striking and startling way to Dr. Still's other grand and primary conception of the body's natural immunity; a conception primary in every sense of that word; for it is upon this great fact of nature that the osteopathic lesion, with all it means to the osteopath and the diseases he works in, hangs. Dr. Still in his own mind and his own writings placed this great natural immunity of the body first in order, and then followed it up with the correction of the lesion, by which procedure the defensive and hence curative mechanism of the body was given free play.


In justice to the original mind of this American genius, it should be said that Dr. Still was the first man to perceive the truth that nature has developed in the animal body its own defenses against diseases. And with this thought in mind we can for the first time see the power and real meaning in his well worn axiom, "Find it, fix it, and leave it alone!"

The three last words contain the heart of the axiom - leave it alone; because by leaving it alone, Dr. Still most certainly did not mean that the practitioner should never touch his patient again! What he did mean was that after the lesion has been corrected nature itself will do all the necessary subsequent work - that is, it is not necessary (nay, it is hurtful) to thrust into the body the drugs that, in his day, were believed by all doctors of all schools to have some effect against the disease at work in the body. "Leave it alone" is nothing but a vigorous protest against drug treatment which in Dr. Still's time was the only treatment for any and all diseases which the surgeons' knife could not remove.


While it is perfectly true, and rightly so, that the osteopath in the past has seemed to rest his entire dependence upon the anatomical lesion (because it was in the correction of these lesions that osteopathy in the beginning worked its most amazing results), it is none the less true that by persistent effort the osteopath has swept under his control diseases which the earlier osteopaths were disposed to neglect as being, in some way or other, outside the domain of the anatomical lesion. Today in the great center and mother institution of osteopathy at Kirksville, a city made world renowned by Dr. Still and the system of therapy he founded, there are young osteopaths, yet in the student stage of their career, who, with entire confidence in their own power and the science under it, treat all kinds of infectious diseases with a courage, or rather with an entire want of fear, that reminds one of the primitive Christians.


All these facts are individual little monuments to the genius of A. T. Still, because they show how well he anticipated the discoveries of the world's most enlightened and capable scientists of later years; and if Europe, with the genius of its laboratories, has given to the world a better understanding of the causes, the prevention, and the rational theory of the cure of diseases, what it has done is only the scientific demonstration of the theory of disease (the natural defenses of the body) which was first perceived and announced as his own theory of disease forty years ago by Andrew Taylor Still. Therefore, we say it is only just to the genius of the man to give to him the credit for having been the first to conceive this theory of immunity to disease, which, during the past twenty-five years, has grown with such rapidity and strength as to fill the whole world with its noise and to change radically all views of diseases and the possibility of their cure.

An extraordinarily high degree of credit should be given him for this remarkable and original perception for the very reason that it came to him at a time when the facts of immunity were not at all understood, nor in any way seen or believed to be concerned with disease in general. At that time, as well as in all previous times, the bare fact of immunity, natural and acquired, was and had been for ages familiar to men. It was a matter of common knowledge and experience that certain diseases in men were followed by immunity to these certain special diseases. It was a fact of common knowledge and experience, for example, that an attack of smallpox was followed by immunity to smallpox in the future; that men perhaps never had a second attack of the disease; that persons having passed through one attack of the disease were universally regarded as being safe against a second attack. Scarlet fever, mumps, yellow fever, measles, and other diseases, called infectious or contagious, were similar to smallpox in their power of conferring immunity against the disease. But this power of conferring immunity was thought to be limited to those diseases alone in which the immunity conferred was lasting throughout the life of the individual. Other diseases, to a second or third or several attacks of which the body was susceptible, were not classified as diseases that immunized the individual. But it is now known that all infectious diseases do produce an immunity, in all ways similar to that produced by smallpox except for the length of time during which the immunity lasts.

If, let us say, pneumonia produces an immunity which safeguards the individual as efficiently as smallpox does, only that the immunity wears out, say in a year or more, you have a similar power to that in smallpox, only the effects do not last a life time. The same is true of typhoid fever, and in deed of all infectious diseases. This will be seen to be necessarily true when it is remembered that if an immunity, more or less lasting, were not produced by the disease, the disease would never disappear, the patient never "get well". So that it would appear that all infections act in the body in a way similar to smallpox but with certain variations in the length of time during which the reaction, or the "safety", lasts. This would bring all infection under the same natural law; but the proof of these facts means only one thing, and that is this, that an individual, not immune to a disease in the first place, but who becomes immune after the disease has been acquired and "runs its course" with recovery, must have in his body previously to the attack some kind of mechanism which the presence of the disease excites to the formation of substances which now are in sufficient quantity to prevent, for a longer or shorter time, a second attack of the disease. This in turn must mean only that the body is equipped by nature with its own cure for disease and with the power of preventing further attacks of the same disease-for a longer or shorter time after the first attack.


Dr. Still urged virtually this view of disease, and held that the curative and protecting thing was to be found in the blood and hence in the tissues, and in this theory, simple as it appears today to us who are familiar with the researches of Europe during the past twenty-five years, is to be found the very first perception of the great law of immunity to disease of almost every kind, including even the tumors. Dr. Still, in effect, urged the theory that all diseases could be scientifically classified with smallpox, and similar immunizing diseases, and that hence all diseases in their cause and cure could be referred back to the blood. His axiom now follows: Remove the cause which stops or clogs the blood flow, or which blocks the nerve which controls the blood flow, and the blood itself will work the cure. "The rule of the artery is supreme."


Now when Dr. Still began to treat diseases on this principle the entire principle itself was not only amazing to the then current ideas of disease, but was also incomprehensible even to the best thought of his time. To bring virtually all diseases under one main principle was, to the science of that day, a complete absurdity. To say that smallpox, tuberculosis, pneumonia, whooping cough, pimples on the face, leprosy, syphilis, typhoid fever, diarrhoea, a "cold" in the head and cancer were one and all referable to the same basic law (the state of the blood) and perhaps curable by the same method, were the whole problem in all its phases mastered, was not only "revolutionary" but was a wildly impossible and clearly absurd theory of disease in its causes and its cure. But let us ask, in the light of the scientific progress of the past quarter of a century just how absurd and impossible it really was?

Since that time the clear sun of science has risen higher and higher every day to dissipate the darkness that shrouded disease up to the day of Still and his discovery. Rather say, sun after sun of science has risen in succession to that first illuminating discovery of Dr. Still. Metchnikoff rose to show how the white cells of the blood ingest disease germs, ridding the body of these destructive agents, and indeed normally preventing the onset of infections; Buchner, the German bacteriologist, rose, showing how ferments could be separated from the organisms that made them; Uhlenhut rose, to show through his pupil Nuttall, how disease germs, multiplying in the animal body, produced in the blood of the animal a substance that could kill the germs that produced it; Pfeiffer, another German, rose to show how the serum of an animal inocculated with typhoid or cholera germs would dissolve typhoid or cholera germs, but no other; Behring, the pupil of the great Koch, rose to show how the poisons of bacteria could produce in the body of the animal into which they were injected a counter substance which could neutralize and render harmless the toxins themselves, calling them anti-toxins; Bordet, the Frenchman, rose to show how these laws applied to the blood cells of other animals when injected into an experimental animal; Ehrlich rose, to show why all these things had to be true and how the mechanism of the body did its work in the cure and prevention of disease; and finally Abderhalden, the youngest of this array of scientists, rose to show how the tumors were to be classified in their general laws with the disease germs, so called, the bacteria of the bacteriologists. Limb after limb of the great problem has been brought under control and more or less understood, and today not to subscribe in full to the principle first laid down by Andrew Taylor Still forty years ago, is to confess one's self as having no knowledge or understanding at all of the progress made by biological science within the past twenty-five years, or (we can say to the uninformed critics of osteopathy) to confess one's self a person with no knowledge or understanding of Andrew Taylor Still and his theory.

With these facts in mind we can see A. T. Still as the original discoverer of one of the great natural laws of living matter, comparable in all ways with other great generalizations, the first perceptions of which were necessarily incomplete so far as actual demonstration by experiment or mathematical calculation is concerned. This theory of Still is deserving of being ranked, within its own special compass, beside the theory of the chemical and physical basis of life - a theory that grew in many minds rather than in one. It is, indeed, a corollary of Darwin's law of natural selection, for it is clear that if all living organisms had not been preserved through their ancestral immunity to disease - through this self-protecting mechanism that saved them from disaster and death by disease - they had never survived at all, the very fact of their survival being of itself indisputable evidence of the presence in their bodies of a defensive and curative force - the old vis medicatrix naturae (the healing force of nature) of the ancient doctors that was ever active and automatically self-adjusting under favorable conditions. To re-establish these favorable conditions, when accident had removed them, was the method proposed by Still for the cure of disease; a method absolutely original with himself, and grounded on the most conspicuous fact of human consciousness - the tendency of some forms of living matter to antagonize and destroy certain other forms of living matter, and thus to survive in the struggle for life-"disease" being mainly a struggle for life among living forms, as for example, destructive "germs" or tumor cells, on the one hand, and the normal cells of the body on the other.


We have said that Still originated many various physiology which have since been found to be in theories concerning normal and pathological adequate or faulty. But in this respect he resembled all other great geniuses in biology and other sciences. The earlier investigators in all sciences were quite outside the truth in many, and indeed in most, of their scientific speculations, and necessarily so. Many osteopaths, while revering the founder of the new system of healing, have seemed to feel, because Still was right in his two grand principles of disease and its therapy, that therefore he should not have been wrong in anything he said about the body and its work, in health and disease. But such osteopaths are shortsighted and unwise. If Dr. Still had been right in all his theories he would not have been human, not worthy of human admiration. His errors, indeed, and he made many, are really a greater glory to his genius than his two great and true discoveries. Dr. Still's very errors would have been accounted discoveries if made by a common man. He lived and worked out his theories forty-five years ago, and earlier. He had thought out a scientific theory to account for the phenomena of cholera, for example, when other men accounted for them by the belief that this disease was a visitation of Providence on the sins of men. His theory of cholera in the light of subsequent discoveries is seen to be untrue, of course, but to originate any kind of a scientific theory at all of this disease in that day was the mark of an original, scientific and profound thinker. His theory of "blood seed", which few of his interpreters have been able to understand, is an identical theory with that of the contemporaries of Theodor Schwann to account for the growth of cells in the body. Dr. Still himself was a contemporary of Schwann, and it is small wonder that the doctors of that day in America could not understand his meaning when he spoke of "blood seed". The American doctors, in that day knew nothing of the cell theory of Schwann, or next to nothing.

Now there was in that day current in the higher scientific circles of Europe a theory of "blood seed", but it was not called by that term. It was known as the "blastema theory". There are probably not many doctors in America today who could tell us what the "blastema theory" was. And why should they, when this theory, like Still's "blood seed" theory, was wiped out by the discovery made later that all cells originate from one cell (the ovum), and that no cell arises except as the continuous splitting-by cell division-of previously existing cells? But the "blastema theory" held that there were in the blood countless millions of invisible particles floating in a special fluid, the "blastema", which had the power of growing large and developing into cells. As a matter of fact, there are in nature certain unicellular animals, such as the organisms that cause smallpox, that do actually grow from invisible units so small that they can pass through the pores of a Berkfeld filter. But the cells of the animal body do not grow in just that way, although the original units or cell development actually exist in the egg cell and its descendants in this inconceivably minute form, and it was upon this conception that the German biologist Weissman founded his wonderful theory of inheritance with its "idants", "ids", "determinants" and "biophors". Now Still, and the other contemporaries of Schwann, held that these minute units (afterwards called "gemmules" by Darwin, "granules" by Altmann and "micellae" and "plastidules" by Haeckel and others), actually floated in the blood and furnished the origin of the cells of the body. In that much, of course, Still and the others were in error, but it is at least an indication of the powerfully original mind of Still that he had hit upon a theory going to the very origin of the cell, similar in all respects to that of the best thinkers of Europe of his day. And we need have no doubt at all that Still, in common with his American colleagues, had no intimate acquaintance at all with the finer-spun biological theories of the Europe of that day.

Again we must remember that Still was a doctor of the old school and that he did not altogether rid himself, as his followers have done, of all the old machinery of the older therapy. We must do him the justice, however, of being consistent in a thorough way in his rejection of internal drug medication. Indeed he held that locomotor ataxia was caused by the mercury administered to the syphlitic rather than by the disease; but this is now known not to be true, although in his day that speculation of his was quite as justifiable as any other on the cause of tabes dorsalis.


It is interesting to observe, however, that of all the old drastic methods of therapy which were in full swing in his own day, only one has retained its vitality, and that is the principle of so-called "counter-irritants". Blisters and strong irritating plasters are potent in certain pains and other symptoms, although the reason why is perfectly obscure. And this principle of counter irritants was perhaps the one prominent therapeutic method of the old time that Still did not abandon. He believed, in a limited way, in counter irritants and used them, sometimes with excellent results, although the results were not always as sure as the cures he wrought when he stuck to his own discovery, osteopathy. His scientific errors and vagaries, however, were remarkably few when compared with the number of similar errors and vagaries of other great scientific reformers of his own day. For example, if we look into the life work of the great Johannes Mueller, founder of modern physiology, and professor of anatomy and physiology in the University of Berlin (while Still was developing his earliest dissatisfactions with medical unwisdom) we will find that perhaps not one of Mueller's wonderful "discoveries" accepted in that day as true - has stood the test of subsequent investigation. Mueller wrote whole textbooks of physiology (previously to 1850) which consisted wholly of experiments and theories all his own. And yet all that remains of the work of this great genius of science is the one theory of the "specific energy of nerves". But do we say therefore that Johannes Mueller is unworthy the monuments the world has raised to him and of the honor we do him proudly today? No, indeed. For Mueller's scientific errors and "vagaries" form the fundamental rock and cornerstone of modern physiological Science, just as the most striking of Still's errors form the fundament of modern drugless therapy, with this difference that Still's theory of immunity has been absolutely demonstrated by every laboratory in Europe, and his practical application of that theory in osteopathy, the American science of mechano-therapy, has given to a suffering humanity a balm unparalleled, and unapproached in the history of the human race.