Philosophy of Osteopathy
Andrew Taylor Still, D.O.




    The five points of observation will cover easily the whole body, and we cannot omit any one of them, and successfully examine any disease of the system.  Local injuries are, however, an exception to this rule, and even a local hurt often causes general effect.  Suppose a fall should jar the lumbar vertebra, and push it at some articulation, front, back, or laterally; say the lumbar, with one or two short ribs turned down against the lumbar nerves with a prolapsed and loosened diaphragm, pressing heavily on the abdominal aorta, vena cava, and thoracic duct; have you not found cause to stop or derange the circulation of blood in arteries, veins, lymphatics and all other organs below diaphragm?  Then heart trouble would be the natural result.  Fibroid tumors, painful monthlies, constipation, diabetes, dyspepsia or any trouble of the system that could come from bad blood would be natural results, because lymph is too old to be pure when it enters the lungs for purifying. If blood or chyle is kept too long below the diaphragm, it becomes diseased before it reaches the lungs, and after renovation, but little good blood is left.  Then the dead matter is separated from blood and blown out at the lungs while in vapor.  Thus nutriment is not great enough to keep up normal supply.  In this stage the patient is low in flesh and feeble generally, because of trouble with blood and chyle to pass normally through the diaphragm.


    The failure of free action of blood produces general debility, congestion, low types of fever, dropsy, constipation, tumefaction and on to the whole list of visceral of diseases.

    From this we are called to the pelvis.  If the innominate bones are twisted on sacrum or are driven too high or too low, an injury to the sacral system of blood and nerves would be cause equal to congestion, inflammation of womb or bladder-diseases, with a crippled condition of all the spinal nerves.  This would be cause enough to produce hysteria, and on to the whole list of diseases to spinal injuries.  The Osteopath has great demands for his powers of reason when he considers the relation of diseases generally to the pelvis; and this knowledge he must have before his work can be attended with success.

    As I said, five points comprise the fields in which the Osteopath must search.  I have given you quite pointedly and at length, hints on spine and sacrum which cover the territory below the diaphragm.  In conclusion I will simply refer you to the chest, neck and brain, and say, "let your search light ever shine bright on the brain." On it we must depend for power.  About all nerves do run through the neck and branch off to supply both above and below, to do their parts in animal life, to the heart, brain and sum total of man and beast.  Search faithfully for cause of diseases in head, neck, chest, spine and pelvis; for all organs, limbs and parts are directly related to and depend on these five localities to which I have just called your attention.

    With your knowledge of anatomy, I am sure you can practice and be successful, and should be in all cases over which Osteopathy is supposed to preside.


    I want to offer you the facts, not advice, but pure and well sustained facts, the only witnesses that ever enter the courts of truth.  A spinal cord is a fact; you see it -- thus a fact.  That which you can see, feel, hear, smell or taste is a fact, and the knowledge of the ability of any one fact to accomplish any one thing, how it accomplishes it and for what purpose, is a truth sought for in philosophy.  The spinal cord is the present fact for consideration.  You see it, you feel it, thus you have two facts with which you can start to obtain a knowledge of the use of this spinal cord.  In it you have one common straight cylinder which is filled with an unknown substance, and by an unknown power wisely directed.  It is wisely formed, located, and protected.  It throws off branches which are wisely located.  They have bundles, many and few; they are connected to their support, which is the brain, by a continuous cord in length and form to suit.  After it has concluded throwing off branches at local places for special purposes, then like a flash-light, it throws off a bundle of branches called horse-tail plexus, caudae equinae, which simply signifies the many branches that convey fluids and influences to the extremities, to execute the vital work for which they are formed and located.  While the laws of life and their procedure to execute and accomplish the work designed by nature for them to do, is mysterious and to the finite mind incomprehensible, you can only see what they do or perform, after the work is done and ready for your inspection.


    Now as we are dealing with the omnipresent nerve principle of animal life, I will tell you this one serious truth, and support it by the fact of observation.  To treat the spine, and thereby irritate the spinal cord oftener than once or twice a week will cause the vital assimilation to be perverted, and become the death-producing excretor, by producing the abortion of the living molecules of life, before fully matured, while in the cellular system, which lies immediately under the lymphatics.

    Your patients will linger long from the change of the nutrient ducts to throw off their dead matter into the excretories, which death was caused by the undue, or two many treatments of the spinal cord.  If you will allow yourself to think for a moment, or think at all of the spinal cord being irritated, and what effect it will have on the uterus y o u will realize that I have told you a truth, and produced an array of facts to stand by that truth.  Many of your patients are well six months before they are discharged.  They are kept on hands because they are weak, and they are weak, because you keep them so from irritating the spinal cord.  Throw off your goggles and receive the rays of the sunlight which forever stand in the bosom of reason.


    This is the most important chapter of this book, because at this point the engine of life is turned over to you as an engineer and by you it is expected to be wisely conducted on its journey.

    Your responsibility here is doubled.  Your first position is that of a master mechanic, who is capable of drawing plans and writing minutely a specification whereby the engineer may know what a well constructed machine is in every particular.  He knows the parts and relations of both as constructor and operator, and you are supposed to be the foreman in the shop of repairs.  The living person is the engine, nature the engineer, and you the master mechanic.

    This being your position it is expected that you will carefully inspect all parts of the engines run into your repair shop, not all variations from the truly normal, and adjust from those variations as nearly as possible to the conditions of the true specimen that stands in the shop.


    At this point it will be proper to suppose a case by way of illustration.  Suppose by some accident the bones of the neck should be thrown at variance from the normal to a bend or twist.  We may then expect inharmony in the circulation of the blood to the head and face with all the organs and glands above the neck.  We will find imperfect supply of blood and other fluids to the head.  We may expect swelling of head and face with local or general misery.  Thus you have a cause for headache, dizziness, blindness, enlarged tonsils, sore tongue, loss of sight, hearing, memory, and on through the list of head diseases, all because of perverted circulation of the fluids of the brain proper of any local division.  It is important to have perfect drainage, for without it, the good results from a treatment cannot be expected to follow your efforts to relieve diseases above the neck.


    Here I want to emphasize that the word treat has but one meaning, that is to know you are, right, and do your work accordingly.  I will only hint, and would feel embarrassed to go any farther than to hint to you, the importance of an undisturbed condition of the five known kinds of nerves, namely: sensation, motion, nutrition, voluntary and involuntary, all of which you must labor to keep in perpetual harmony while treating any disease of the head, neck, chest, abdomen, pelvis, spine and limbs.

    If you would allow yourself to reason at all, you must know that sensation must be normal and always on guard to give notice by local or general misery, of unnatural accumulation of the circulating fluids.  Each set of nerves must be free to act and do their part.  Your duty as a master mechanic is to know that the engine is kept in so perfect a condition that there will be no functional disturbance to any nerve, vein, or artery that supplies and governs the skin, the fascia, the muscle, the blood or any fluid that should freely circulate to sustain life and renovate the system from deposits that would cause what we call disease.


    Your Osteopathic knowledge has surely taught you, that with an intimate acquaintance with the nerve and blood supply, you can arrive at a knowledge of the hidden cause of disease, and conduct your treatment to a successful termination.  This is not by your knowledge of chemistry, but by the absolute knowledge of what is in man.  What is normal, and what abnormal, what is effect and how to find the cause.  Do you ever suspect renal or bladder trouble without first receiving knowledge from your patient, that there is soreness and tenderness in the region of the kidneys at some point along the spine.  By this knowledge you are invited to explore the spine for the purpose of ascertaining whether it is. normal or not.  If by your intimate acquaintance and observance of a normal spine you should detect an abnormal form although it be small, you are then admonished to look out for disease of kidneys, bladder or both, from the discovered cause for disturbance of the renal nerves by such displacement, or some slight variation from the normal in the articulation of the spine.  If this is not worthy of your attention, your mind is surely too crude to observe those fine beginnings that lead to death.  Your skill would be of little use in incipient cases of Bright's disease of the kidneys.  Has not your acquaintance with the human body opened your mind's eye to observe that in the laboratory of the human body, the most wonderful chemical results are being accomplished every day, minute and hour of your life?  Can that laboratory be running in good order and tolerate the forming of a gall or bladder stone?  Does not the body generate acids, alkalies, substances and fluids necessary to wash out all impurities?  If you think an unerring God has made all those necessary preparations, why not so assert, and stand upon that stone?  You cannot do otherwise, and not betray your ignorance to the thinking world.  If in the human body you can find the most wonderful chemical laboratory mind can conceive of, why not give more of your tiuie to that subject, that you may obtain a better understanding of its workings?  Can you afford to treat your patients without such qualification?  Is it not ignorance of the workings of this Divine law that has given birth to the foundationless nightmare that now prevails to such an alarming extent all over civilization, that a deadly drug will prove its efficacy in warding off disease in a better way than has been prescribed by the intelligent God, who has formulated and combined life, mind and matter in such a manner that it becomes the connecting link between a world of mind, and that element known as matter?  Can a deep philosopher do otherwise than conclude that nature has placed in man all the, qualities for his comfort and longevity?  Or will he drink that which is deadly, and cast his vote for the crucifixion of knowledge?