Dr. A. T. Still Founder of Osteopathy
M. A. Lane
In the first part of this, our study of Dr. A. T. Still, we looked at him in his capacity as one of the great original thinkers and reformers in the sciences called medical. We showed how he was the first to state outright, in unequivocal and clear terms, the great theory of immunity, or rather how A. T. Still was the first to perceive the fact that immunity applied not only to the diseases which, up to his time, were regarded as immunizing diseases, but urged in clear terms the universality of this great modern biological principle in diseases of every kind. We showed that to him belongs the credit of having brought all diseases under one great law - that of body resistence; how, theoretically, the blood and the tissues themselves contained the cure for diseases of virtually every kind. We called attention to his wonderful perception of the fact that by certain mechanical manipulations of the body structures, especially those of the spine, this natural resistence to disease could be released from certain obscure interferences, or increased in quantity in certain other circumstances, obscure enough in themselves. Thus rose in his perception the osteopathic lesion, which, he claimed, was probably at the source of most, if not all, disturbances of the body called pathological. And we further called attention to his logical abandonment of virtually all the older methods of medication which, in his day, consisted chiefly of drugs, foreign to the substances of which the body consists, all of which he regarded as poisons or hurts to the natural mechanism of the body itself. We have now to study Dr. Still in the practical application of these principles, or, in other words, to study the master at work with the theoretical tools he invented to realize his theories in fact. And in this study we shall find that Dr. Still was an absolute osteopath, consistent in all ways with his main theoretical findings.


The present writer appreciates the difficulties that would confront any man in a study of this kind, for it is hard to separate Dr. Still's own theories and position from those of many of his followers, who have developed the art that he founded, and have made applications of that art in their own way, with their own modifications. We believe, however, that few osteopaths, who have remained osteopathic, and have not become infected with certain delusions that control the minds of many unscientific medical doctors, will disagree with our statements of fact. A fair review of Dr. Still's work will deal only with his main generalizations, neglecting his adventitious speculations on certain phases of physiology which later investigation has diverted widely from the thought that was current in his own day. To remain a pure osteopath was difficult even for the founder himself, but that does not justify the modern osteopath for departing one jot from the main pure osteopathic principles for which A. T. Still stood and which are entirely and altogether responsible for the magnificent success that is the fruit of osteopathy today. It is probable that had Dr. Still remained in active life long enough to have become acquainted with the results of recent scientific research, he had needed no interpreter such as the present writer, but would have been able to vindicate his own early theory and practice with his own pen, as he was fully able to do. And had he so lived and wrought he would have continued the purest osteopath in the profession he fathered.


You will ask, what do you mean by a pure osteopath? We mean by that term an osteopath who treats disease by manipulating according to osteopathic technique the tissues of the body, especially the tissues that constitute and support the back bone and the nerves that issue between the vertebrae. This manipulation, however, has no hard and fast system, but can and does vary from a single movement by which "sub-luxations", great or small, or any other unusual stress, tension, or deflection may be removed, to a general treatment, in which the entire vertebral column and its anatomical clothes are thoroughly relaxed and readjusted. As long as the osteopath uses his hands in his therapy, he may be called a pure osteopath. The very moment he adopts any other procedure whatever he is no longer using osteopathy. We do not mean by this, as some of the unthinking and uninformed critics of osteopathy imagine, that an osteopath must necessarily be a stupendous fool, who would attempt to stop a hemorrhage from the ears in fracture of the skull by manipulating the back bone, or who would hold that insects do not transmit disease germs, or who would deny any other known and proved fact. To be an osteopath of any intelligence whatsoever implies that the man in practice is a normal, sane human being.
In a strict definition of the term "pure osteopathy", or, as many of us call it for short, "tenfinger osteopathy", we need not exclude the use of rational methods of hygiene or diet, nor indeed any other scientific regimen that would back up pure osteopathic treatment. But the fact of the matter is that many osteopaths extend their definition too far. We do not believe that Dr. Still would have accepted this modern enlargement of his own term. To say that any method which cures disease or which assists nature in recoveries or reactions against disease is osteopathic is not at all true; but we do not understand that Dr. Still has ever held that osteopathy itself, as a general therapeutic agent, was opposed to all kinds of hygiene, diet, sanitation, or therapy other than osteopathic manipulation. To hold such a view would truly be "more royal than the king." And yet until the last word in osteopathic science has been said, and the last possible experiment in osteopathic research has been made, no man can positively assert that pure osteopathic manipulation will not eventually be found to be all that is necessary in the treatment of disease, and by that we mean all diseases, including even the tumors. Nor can this belief be set aside as the dream of the enthusiast. On the contrary, such a belief will emerge from a study of osteopathic results - at least in man - made with a little actual first-hand knowledge of the body in health and disease as a working foundation for the study itself.


Now Dr. Still found that when he laid his hands, in certain definite ways, on the back bone of a man, the body (and mind) of the individual gave back immediate and profound reactions - what the biologists call tropisms; and this one recent biological term tells the biologist absolutely the entire osteopathic story; explains to the biologist absolutely everything that does or can occur when this method is used on the body.

Tropisms are the reactions of an organism to changes in the environment, and the human organism is highly susceptible (in common with all other living things) to such fundamental relations. Profound chemical changes can be brought about in the central nervous system (and hence in the viscera) by stimulation of the nerve endings in the skin. A prolonged cold bath, for example, will cause albumin to appear in the urine.
But Dr. Still found that manipulation, in certain ways, of the spinal column and its dependent tissues produced certain startling and special reactions, and this was strikingly the case when ever there was in the back bone any visible or palpable irregularity or lesion or deflection. His studies of the spinal mechanism led him to the conviction that virtually all so-called diseases, pains, symptoms, and so on, were indirectly caused by these spinal lesions, when other anatomical lesions, or displacements, or tensions, or other structural defects, were absent elsewhere. Disease, in this way, quickly resolved itself, in his mind, into two grand divisions - local and systemic. It is difficult, often impossible, to find a spinal lesion (of any kind) in a given case. Therefore must we say it does not exist? By no means. The spinal column has been developed into a mechanism which, by its very structure, is subject to continuous bony displacements and to continuous automatic correction of these displacements. But this corrective mechanism is by no means perfect, and it is rational to hold that every spine is subject to a certain percentage of displacements that do not correct themselves. These displacements may be so fine as to be difficult to find, but it is safe to say they are there nevertheless.
It must be admitted that in this view of things there is considerable assumption, but such assumption certainly seems warranted when the matter is given sufficient thought, and the more it is studied the higher the warrant becomes. We must not forget, however, that however high the warrant, it is still assumption, but assumption is always necessary in every theory of science. The generic law of the spinal lesion is peculiar to osteopathy, but it must be remembered, too, that osteopathy includes all anatomical lesions other than spinal. It is hardly necessary to state that fact.

With these main theories in mind Dr. Still began the practice of the therapy he afterwards called osteopathy, and in a few years, with no other method to help him, he made the name of Kirksville, the city of his residence, famous throughout the world, by working out the numerous and seemingly miraculous cures, which the practitioners of his school have been continuing in the years that have followed.

It is clear, however, that the spinal lesion as a cause of disease must be regarded from two points of view, and that two kinds of lesions must be considered. There are what may be called primary lesions - originating in the vertebral column itself, and acting reflexly upon other parts of the body; and lesions secondary in the spine, originating in other parts of the body, and registered in the spine itself - injuries in the spinal tissues, produced, for example, by toxins, the sources of which are remote from the spinal tissues. So, too, there may be in the spine bony lesions-displacements of the vertebrae, or apart from these, and existing without them, certain stiffnesses, tensions, contractures, or other changes in the ligaments and musculature of the spine. It is clear now that if the lesions be primary in the spine their correction should re-establish health. But it is not so clear that the correction of secondary lesions, especially muscle lesions, will be followed by the same results. And in this crux of his work the real genius of Dr. Still is seen. As the very fundamental principle of his theory, therefore, Dr. Still asserted that the blood and the tissues had in them a chemical mechanism that was nature's own prevention and cure of disease. "You do not need drugs," he said. "The blood has a hundred drugs of its own of which the doctor knows nothing. But the body's drugs actually cure the disease, whereas the doctor's drugs kill."


The lesion in the spine, blocking the free flow of blood to any part of the body, interferes with the chemical conduct of the body, and with the lifting of this embargo nature itself does the necessary work to restore the body to its normal state and even beyond it. Now this principle, as we saw in the first part of our study, is nothing more or less than the first announcement of the general fact of immunity, a principle that has, since Dr. Still's discovery, replaced all other theories of disease and its possible cure.


It has been truly and wisely said that Dr. Still's one grand discovery as a practical therapist was the fact that one human body, with all its wonderful structure and function, with all its marvelous resources and susceptibilities, could be brought under the control of another individual, who, with intelligent understanding of anatomy and the application of the special technique worked out by Dr. Still, could play upon the mechanism of that body as the skilled performer plays upon the complex musical instrument.

No figure of speech, however, is needed to realize the fact Dr. Still gave to the world a system of therapy absolutely original in every one of its applications; that he at one stroke not only cast aside, in a thorough-going and radical way, the entire system of medical practice with its purges and emetics, its alteratives and demulcents, its anodynes and cholagogues, its stimulants and sedatives, and its thousand and one other superstitions that had fogged the brain and paralyzed the hand of therapy for ages - cleaned out the whole system at one stroke - and replaced it with a practice grounded upon the most striking generalization of physiological science the world has ever known. He gave to the world this entirely new method of treating diseases, the result of which are unparalleled and unapproached in human history. For up to the time of that discovery there was positively no method of treating diseases in general that was followed by any results whatsoever save harmful ones. The only system of therapy at all comparable with osteopathy that has appeared since his time, is that of serum and vaccine therapy, and this has been found to have fallen immeasurably below its first promise and expectation. But serum and vaccine therapy, let it always be remembered, was founded on the identical principle of Dr. Still himself the body's own natural resistance to disease of every kind. And this therapy is general in no sense of that word. So that we can truly say that osteopathy is the only scientific, universal therapy as yet put into practice, which in no form whatever depends upon or grows out of any other system or method or theory since men first attempted the treatment of disease by means other than those of the medicine man of the savage tribe, who called in the supernatural to his assistance.

With this absolutely unique and perfectly original method in their hands, the pupils of Dr. Still, the men and women trained under his influence, have been treating diseases of every description for twenty years or more, and he would indeed be a man of neither common sense nor ordinary fairness nor openness of mind who would deny the results the profession of osteopathy has won with no other method than that of what has been called pure osteopathy by the foremost and oldest practitioners of the art. These results have been culled from thousands of bed-sides and from tens of thousands of cases pronounced hopeless, or incurable, by other practitioners of medicine, who have seen with startled curiosity and vain regret the osteopathic tide, as it has swept such incurables into the ranks of perfectly healthy men, women and children. Into all fields and all specialties of medicine has osteopathy entered, and each and every one of the cured incurables has become in turn a new prophet and propagandist, with spontaneous testimony as to the virtue of the method in each particular case.

In this respect, too, osteopathy has differed most essentially from the two other main special reforms in medicine. We mean homeopathy and eclecticism - the schools of Hahnemann and Bennett. The great Osler could truly say that the homeopaths, who used virtually no medicine at all, lost as few patients as the old school with poisonous drugs. Indeed they lost fewer. But homeopathy, with its vanishing quantities of drugs, did not cure patients whom the older school dismissed as incurables. And this is precisely what Dr. Still did time and again until his retirement from active life, and what every practitioner of his school has done from the beginning, and is doing every day. These facts form the popular foundation on which the success of osteopathy rests, and this foundation only grows, and can only grow deeper and stronger with the passage of time, as the number of practicing osteopaths increases year by year, and the known results of their practice correspondingly increase.

But the curing of incurables is not by any means the limits of the method, for it must be remembered that the older doctors have been accustomed to confuse the terms "curable" and "recoverable". All diseases from which the patient naturally recovers have been classified as "curable" by the medical profession. But thus far, the diseases that have been cured by the medical art (apart from osteopathic medical art) can be counted on the fingers of one hand.

Dr. Still, going to the heart of the matter, said, in his almost too gigantic way, "I looked around me and asked myself where were the patients we, the doctors, had been treating for disease? And I was compelled to answer, `They are dead!'-And it was then that I realized that something was wrong with medicine."

It is perfectly safe to say that there never has been a physician from Lieberkuehn to Osler who has not, in his thoughtful moments, felt the same intense conviction that was expressed by Dr. Still in the above words, but the likeness between him and all the others (save four or five) stopped right there. It remained for him to find out what was wrong, to remove the error, and to put in its stead a practical and scientific substitute, and that substitute is osteopathy. What, now, was the error? The answer may be expressed in one word - drugs. And as early as the year 1873 - and earlier - Dr. Still, with one supreme wave of his hand, swept the entire system of drug therapy clear out, root and branch, replacing it with what he called, for want of a better name, Osteopathy. It is difficult for us in these days when osteopathic therapy is one of the established facts of the day to realize the hugeness of Dr. Still's achievement. To realize it fully we must forget what has occurred during the past forty years, place ourselves back with him in 1873, and become conscious of this huge naked fact:

Andrew Taylor Still was not only the originator of manual therapy, but he also (and this is a huger fact) was the originator of drugless medicine!

Drugless medicine is today a fact of universal recognition and force - a fact familiar to the whole world, and perhaps the only forward step that medicine has taken since the time of the ancients; for it is hardly fair to regard the vaccines and the serums of modern times as true drugs, although they are so classified by their users. Nor is it fair to discount the full and sole credit for this great and radical reform which should spontaneously flow to Dr. Still, on the ground that the time was ripe, that drugless medicine was coming anyway, and that if he did not establish it some other man would have done so. Quite true. It would have been established by some other genius of prime order. But the same thing may be said with equal force of all other great reforms whatsoever. Nor yet can we discount that credit by saying that Flaubert, the French physician of the late eighteenth and early nineteenth century, was the first modern to see the vanity and futility of the ancient apothecary system, so well set forth in the realistic novel, Madame Bovary, published about 1850 by his son, Gustave Flaubert, a book that everybody interested in medicine should read. Flaubert's perception was without force and effect, and the entire drug system was absolutely intact afterwards. Nor can we deprive Dr. Still of the entire credit for drugless medicine by saying 'that the physiologists of the middle nineteenth century were beginning to become convinced that the "remedies" of medicine were in reality poisons - a principle which was afterwards formulated in the pharmacological maxim that all substances that are chemically active in the body are either foods or poisons, and that any substance chemically active in the body that is not a food is therefore a poison.

But what do these facts mean? They mean that Dr. Still's original perception and theory of the action of drugs has been experimentally proved by all the pharmacologists of the world in the past twenty-five or thirty years. We will recur to this matter in a moment. Nor can we classify Hahnemann and Bennett with Still in this respect. For while the great German and the great Scotch reformer of medicine, like the great American reformer, perceived that there was something radically wrong with the medicine of their day, they did no more in the actual practices they founded than substitute one system of drugging for another; the German, indeed, enlarging the number of drugs in use, but reducing the dose to the vanishing point; the Scotchman, on the other hand, increasing the dose by increasing the strength of the drug - the "specific", fresh extracted drugs of the eclectic. Nor yet can we discount Still's great reform by saying that Virchow, the founder of modern pathology, indirectly demonstrated the futility of drugs by his studies of the tissues of disease, because the lesson that Virchow taught had no practical result against the use of the old remedies, neither in the beginning of his work nor since. Thus if we consider all the elements of reform that were working out the general movement that culminated in the drugless medicine and manual therapy of Still, we will see that his grand generalizations were quite in dependent of and uninfluenced by these various elements. They were made by a man quite free from all influence of Flaubert, or of Virchow, or of the early physiologists, and of course of Hahnemann and Bennett, for these men were still held fast in the meshes of the drug net. And we can not say that Still was influenced by the researches of pharmacology, for these researches did not become scientifically organized and progressive until long after the drugless manual therapy of Still was a fact familiar to everybody in America.


Pharmacology is the science which studies the effects of drugs on the animal body. This science had its beginnings in the experiments which were made by physiologists in the administration of various drugs to animals, principally dogs, and the careful recording of such effects by means of instruments of precision, invented for that purpose. In this way the action of many alkaloids, such as pilocarpin, atropine, strychnine, and others, came to be fully understood, one drug playing the part of antagonist to the other, and the entire effect being recorded on the kymograph - a revolving drum covered with smoked paper on which was written the cure of the blood pressure and respiration. The effects of adrenalin on the blood were demonstrated by this technique, thus suggesting some of the normal effects of the secretion of the adrenal gland in the body. By other and more refined methods of research the effects of nicotine on the nerve centers were brought into view. Also the physiological effects of numerous drugs, administered freely to their human subjects by physicians, were studied carefully, and many new perceptions of normal physiology were thus made by the researchers. But incidentally was brought out the fact that all drugs were harmful through the chemical anarchy they produced in the organs of the body.

These investigations and their conclusions were at first unknown to the medical profession at large; but when that profession began to understand the meaning of the results of pharmacological science, its members rose up in fierce denunciation of the pharmacologists - charging these gentlemen with drawing conclusions unwarranted by their experiments, and holding that they had no business or right to reason from dogs to man that because a drug had this or that effect upon a dog was no reason why it should have the same effect upon the human body. The doctors saw that the whole drug therapy was being undermined, and that the medical man, deprived of the use of drugs, would be deprived of the only therapy he had! Therefore, the medical man fought the pharmacologists with the same malicious weapon with which he had long been trying to fight osteopathic treatment and A. T. Still, its discoverer.  But the pharmacologists kept on playing, and soon a course in pharmacology became an essential in the up-to-date medical school - a course which was calculated to leave the medical man at least partly informed in the effects of the drugs he would use, did he use drugs at all . And at this juncture we began to hear, in the medical schools, much talk concerning "preventive medicine," a medicine drugless quite, but distinctly not therapeutic. What has been the result? The result has been this, that drugs are clear out of court in the general practice of medicine by every well informed and scientifically instructed doctor in America. Treatment has vanished in diagnosis, and the main desideratum of every physician is to find out what it is that ails his patient (the name of the disease), the "treatment" being a wholly problematical matter. In this way has science again confirmed one of the main generalizations of A. T. Still.


A fair appreciation of the work that Dr. Still did may be summarized under a few heads.

He was the first to perceive the fact that the animal body had in it, developed by the necessities of the preservation of living forms against obliteration by the destructive agents of disease, and other destructive agents, a natural inherited mechanism of resistance or defense which causes the blood and tissues to react against disease and establish recovery or cure.

He was the first to extend this principle of immunity to virtually all diseases (so called) whatsoever.

He was the first to put into practice the perception that artificially compounded substances called drugs were not only not remedies for disease, but were positively hurtful to the organism, and interferers with the natural mechanism of defense. He was the originator of drugless medicine.

He was the first to found a therapy on mechanical principles, that was calculated to help the body in its efforts to re-establish new physiological equilibriums - new normal states - after disease, in any of its forms, had invaded the body; or when the body was thrown out of its normal action by mechanical (anatomical) lesions.

He was the first to establish a general method of profoundly altering the chemisms of the body (in a way favorable to health and free functioning) by profoundly altering the body's environment, through the use of the hands, in definite manipulations, along the spinal column and its tissues. In other words, he was the first to apply the biological principle of tropisms to an actual therapy, the results of which could not but be good.

These, in brief, were the contributions of A. T. Still to medical science and art, and it is probable that as much can be said for no other man in the history of the medical sciences themselves, when actual practice and results are the things in dispute.


If we analyze this system of manual therapy, called osteopathy by its discoverer and protagonist, we shall see that it is by no means the simple thing that so many practitioners of medicine, who have not inquired into its methods and results, have imagined and imagine to this day.

In the first place it is anything but a massage, except in so far as the hands are used in its application. It is based first on natural body resistance to disease, in which must be figured not only the normal histological (and microscopic) anatomy of the body, to say nothing at all of the gross anatomy in which the microscopic structures mass themselves, but also upon the pathological changes (the reactions) that occur in these structures in disease. It is based upon the internal tropisms of the body organism, brought about by the chemistry, or chemisms, of the blood and lymph - a chemism which Dr. Still thrust vigorously forward as his main proposition. It sweeps under its views all the changes that occur in this complex body mechanism because of mechanical faults, whatever their origin, in that gross anatomical structure. It figures the correction of these faults, especially in the spine, as being virtuous in the cure of disease, whether the tissue faults be primary in the spine (or other structure) or secondary in these structures, through the presence of toxins or poisons in the blood, produced and thrown into the blood by the growth of disease germs anywhere in the body. It figures that osteopathic manipulation of the spine, in a theoretically normal state, can and does produce an exaggeration of the body's reaction against the toxins of the body's own activities, an effect the osteopath calls stimulation. But this stimulation not only involves stimulation of organs such as the liver and all other glands, and the Involuntary musculature of the body, but stimulation also of those cells that manufacture the antibodies to the germs of disease and their toxins, thus increasing the "antibody content" of the blood, which we may now regard as normal secretions, quite as much as we so regard the gastric juice, the bile, or the products of the internal-secreting organs, the ductless glands - as normal secretions.


To say that this sort of physiological oil for the body's machinery is simple, is saying more than the barest inquiry into the facts will warrant. A certain widely known writer on internal secretions has said that the osteopath secures his results by stimulating the ductless gland, and this may be so. But until more is known about the ductless glands than is known at present or until it is established that every cell in the body is an individual ductless gland in itself, we can proceed on the theory announced in general terms by Dr. Still himself, that the fingers of the osteopath release the general mechanism of the body against disease in whatever ultimate structure this mechanism may lie, if indeed it lies anywhere in particular. So that we can add another adjective to Dr. Still's idea - that of being general in its principle and application.

In conclusion we can say that the facts of osteopathy, especially in its bearing upon the demonstrable facts of immunity, offers one of the most alluring fields for practical laboratory experiment and we can add, furthermore, that research is not wanting the purpose of which is to put into the test-tube the results which the osteopath's fingers can work, not only in the human body but in the bodies of those humbler animals that have given to biological science the most striking generalizations it has. But such a work would only put the cap-stone on the grand edifice already reared by Dr. A. T. Still long before test-tubes or microscopes were ever dreamed of in this particular way, and not long before science, in the person of Brown-Sequard, had suggested that in internal secretion would probably be found the key to the mysteries of health and disease themselves.