Philosophy of Osteopathy
Andrew Taylor Still, D.O.
Let us halt at the origin of the splanchnic and take
a look. At this point we see the lower branches; sensation, motion,
and nutrition, all slant above the diaphragm pointing to the solar plexus
which sends off branches to pudic and sacral plexus of sensory system of
nerves; just at the place to join the life giving ganglion of sacrum with
orders from the brain to keep the process of blood forming in full motion
all the time. A question arises, how is this motion supplied and
from where? The answer is by the brain as nerve supply, heart as
blood supply, all of which comes from above the diaphragm, to keep machinery
in form and supplied with motion, that it may be able to generate chyle
to send back to heart, to be formed into blood and thrown into arteries
to build all parts as needed, and keep brain fed up to its normal supply
of power generating needs. We see above the diaphragm, the lungs,
heart and brain, the three sources of blood and nerve supply. All
three are guarded by strong walls, that they may do their part in keeping
up the life supply as far as blood and nerve force is required. But
as they generate no blood nor nerve material, they must take the place
of manufactories and purchase material from a foreign land, to be able
to have an abundance all the time. We see nature has placed its manufacturies
above a given line in the breast, and grows the crude material below said
line. Now as growth means motion and supply, we must combine in a
friendly way, and conduct the force from above to the region below the
septum or diaphragm, that we may use the powers as needed. This wall
must and does have openings to let blood and nerves penetrate with supply
and force to do the work of manufacturing.
A STRUGGLE WITH NATURE.
After all this has been done and a twist, pressure
or obstructing fold should appear from any cause, would we not have a cut
off of motion to return chyle, sensation to supply vitality, and venous
motion to carry off arterial supply that has been driven from heart above?
Have we not found the cause to stop all processes of life below diaphragm?
In short, are we not in a condition to soon be in a complete state of stagnation?
As soon as the arteries have filled the venous system, which is without
sensation to return blood to the heart, then the heart can do nothing but
wear out its energies trying to drive blood into a dead being below the
diaphragm known as the venous system. It is dead until sensation
reaches the vein from the sacral and pudic plexus.
LESSON OF CAUSE AND EFFECT.
Previous to all discoveries that have been made a
demand for the usefulness of such discovery, is felt and talked of for
years, centuries and cycles of time. Its discovery is an open question
and free to all, because in this fact all are interested. That lack
may be felt and spoken of by all agriculturists, and the inquiry directed
to a better plow, a better sickle or mowing machine with which to reap
standing grain. The thinker reduces his thoughts to practice, and
cuts the grain, leaving it in such condition that a raker is needed to
bunch it previous to binding.
His victory is heralded to the world as king of the
harvest, and so accepted. The discoverer says, "I wish 1 could bunch
that grain." He begins to reason from the great principle of cause and
effect, and sleeps not until he has added to his already made discovery,
an addition so ingeniously constructed that it will drop the grain in bunches
ready for the binder. The discoverer stands by and sees in the form
of a human being hands, arms and a band; he watches the motion then starts
in to rustle with cause and effect again. He thinks and sweats day
and night, and by the genius of thought produces a machine to bind the
grain. By this time another suggestion arises, how to separate the
wheat as the machine journeys in its cutting process. To his
convictions nothing will solve this problem but mental action.
He thinks and dreams of cause and effect. His mind seems to forget
all the words of his mother tongue but cause and effect. He talks
and preaches cause and effect in so many places that his associates begin
to think he is mentally failing, and will soon be a subject for the asylum.
He becomes disgusted with their lack of appreciation, seeks seclusion and
formulates the desired addition and threshes the grain ready for the bag.
He has solved the question and proved to his neighbors that the asylum
was built for them, not for him. With cause and effect which is ever
before the philosopher's eye, he ploughs the ocean regardless of the furious
waves, he dreads not the storms on the seas, because he has so constructed
a vessel with a resistance superior to the force of the lashing waves of
the ocean, and the world scores him another victory. He opens his
mouth and says by the law of cause and effect I will talk to my mother
who is hundreds of miles away. He disturbs her rest by the rattling
of a little electric bell in her room. Tremblingly the aged mother
approaches the telephone and asks "Who is there?" And is answered, "It
is me, Jimmie," and asks, "To whom am I talking?" She says "Mrs.
Sarah Murphy." He says, "God bless you, mother; I am at Galveston, Texas,
and you are in Boston, Mass." "She laughs and cries with joy; he
hears every emotion of her trembling voice. She says to him, "You
have succeeded at last. I have never doubted your final success,
notwithstanding the neighbors have annoyed me almost to death, telling
me you would land in the asylum, because no man could talk so as to be
heard 1000 miles away; his lungs were too weak, and his tongue too short."
Now, friends, I have given you a long introductory
foundation previous to giving you the cause of disease, with the philosophy
that I have given upon cause and effect. I think it absolutely clear
and the effect so unerring in its results, that with Pythagoras I can say
SOMETHING OF MEDICAL ETIQUETTE.
To know we have found a general cause for disease,
one that will stand the heights and depths of direct and cross examinations,
as given by the high courts of cool headed reason, has been the mental
effort of all doctors and healers, since time began its record. They
have had to treat disease as best they could, by such methods as customs
had established as the best known for such diseases; notwithstanding their
failures and the great mortality under such a system of treatment.
They have not felt justified to go beyond the rules of symptomatology as
adopted by their schools, with diagnosis, prognosis and treatment.
Should they digress from the rules of the etiquette of their alma maters
they would lose the brotherly love and support of the medical association
to which they belong, under the belief that, "A bad name is as bad as death
to a dog."
THE MEDICAL DOCTOR.
He says that in union there is safety, and resolves
to stick to, live and do as his school has disciplined all its pupils,
with this command, "The day thou eatest thereof, thou shalt surely die.
Stick to the brotherhood."
FOR TRUTH MUST BE INDEPENDENT.
The explorer for truth must first declare his independence
of all obligations or brotherhoods of any kind whatsoever. He must
be free to think and reason. He must establish his observatory upon
hills of his own; he must establish them above the imaginary high planes
of rulers, kings, professors of schools of all kinds and denominations.
He must be the Czar of his own mental empire, unincumbered with anything
that will annoy while he makes his observations. I believe the reasons
are so plain, so easily comprehended, the facts in its support so brilliant,
that I will offer the same, though I be slaughtered on the altar of bigotry
and intolerance. This philosophy is not intended for minds not thoroughly
well posted by dissection and otherwise of the whole human anatomy.
You must know its physiological laboratories and workings with the brain
as the battery, the lungs as the source or machine that renovates the blood
from all impurities, and the heart as the living engine or quarter-master,
whose duty is to supply the commissaries with blood and other fluids to
all divisions and subdivisions of the human body, which is busily engaged
producing material suited to the production of bone and muscle, and all
other substances necessary to keep the machinery of life in full force
Without this knowledge on the part of the reader,
the words of this philosophy will fall as blanks before reaching his magazine
of reason. Thus this is addressed to the independent man or woman
that can, will and does reason.
THE DIAPHRAGM INTRODUCED.
At this point we will introduce the diaphragm, which
separates the heart, lungs and brain from the organs of life that are limited
to the abdomen and pelvis. A question arises at this point; what
has the diaphragm to do with good or bad health? At this time we
will analyze the diaphragm; we will examine its construction, and its uses;
we will examine its openings through which blood passes both above and
below. We will examine the opening through which food passes to stomach.
We will carefully examine the passage or opening for nerve supply to the
abdomen below, to run this great system of chemistry, which is producing
the various kinds of substances necessary to the hard and soft parts of
the body. We must know the nerve supply of the lymphatics, womb,
liver, kidneys, pancreas, the generative organs, what they are, what they
do, and what are demanded of them, before we are able to feed our own minds
from the cup that contains the essence of reason as expressed from the
tree of life.
A USEFUL STUDY.
The diaphragm surely gives much food to the one who
would search for the great whys of disease as reported causes seem to be
far back in the fogs of mystery. It may help us to arrive at some
facts if we take each organ and division and make a full acquaintance of
all its parts and uses before we combine it with others.
In all ages, the Doctor has for lack of knowledge
of the true cause of diseases, combatted effects with his remedies.
He treats pain with remedies to deaden pain; congestion to wash out overplus
of blood that has been carried to parts or organs of the body by arteries
of blood and channels of secretions and not taken up and passed out and
off by the excretories. He sees the abnormal size and leaves the
hunting of the cause that has given growth to such proportions, and begins
to seek rest and ease for his patient. Then he treats to reduce by
medicine to carry the waste fluids to bowels, bladder and skin, with tonics
to give strength and stimulants to increase the action of the heart in
order to force local deposits to the general excretory system. At
this time let the Osteopathic Doctor take a close hunt for any fold in
muscles of the system that would cause a cut-off of
the normal supply of blood or suspend the action of nerves whose office
is to give power and action to the excretory system sufficient to keep
the dead matter carried off as fast as it accumulates. Let us stop
and acquaint ourselves with the true condition of the diaphragm.
It must be normal in place, as it is so situated that it will admit of
no abnormality. It must be kept stretched, just as Nature arranged
that it should, like a drum-head. It is attached all around to the
chest, though it crosses five or six ribs on its descent from the seventh
rib to the sternum at the lower. point and down to fourth lumbar vertebra.
It is a continuous slanting floor, above bowels and abdominal organs, and
below heart and lungs. It must, by all reason, be kept
normal in tightness at all places, without a fold or wrinkle, that
could press the aorta, nerves, Esophagus, or anything that contributes
to the supply or circulation of any vital substance. Now can there
be any move in spine or ribs that would or could change the normal shape
of the diaphragm? If so, where and why?
IS LEAST UNDERSTOOD.
The diaphragm is possibly the least understood as
being the cause of more diseases, when its supports are not all in line
and normal position, than any other part of the body. It has many
openings through which nerves, blood and food pass while going from chest
to all parts below. It begins at the lower end of the breast-bone
and crosses to ribs back and down, in a slanting direction to the third
or fourth lumbar vertebra. Like an apron, it holds all that is above
it up, such as heart and lungs, and is the fence that divides the organs
of the abdomen from the chest. Below it are the stomach, bowels,
liver, spleen, kidneys, pancreas, womb, bladder; also the great system
of lymphatics of the whole blood and nerve supply of the organs and systems
of nutrition and life supply. All parts of the body have a direct
or indirect connection with this great separating muscle. It assists
in breathing, in all animals, when normal, and when prolapsed by the falling
in and down of any of the five or six ribs by which it is supported in
place, then we suffer from the effects of suspended normal arterial supply,
and venous stagnation below diaphragm. The aorta meets resistance
as it goes down with blood to nourish, and the vein as it goes back with
impurities contained in venous blood, also meets an obstruction at the
diaphragm, as it returns to the heart through the vena cava, because of
the packing of a fallen diaphragm on and about the blood vessels that must
not be obstructed. Thus heart trouble, lung disease, brain, liver,
womb, tumors of the abdomen and through the list of effects can be traced
to the diaphragm as the cause.
I am strongly impressed that the diaphragm has much
to do in keeping all the machinery and organs of life in a healthy condition,
and will try and give some of the reasons why, as I now understand them.
First, it is found to be wisely located just below the heart and lungs;
one being the engine of the blood, and the other is the engine of the air.
This strong wall holds all substances or other bodies away from any chance
to press on either engine, while performing their parts in the economy
of life. Each engine has a sacred duty to perform under the penal
law of death to itself and all other divisions of the whole being, man.
If it should neglect its work of which it is a vital part, should we take
down this wall and allow the liver, stomach and spleen to occupy any of
the places allotted to these engines of life, a confusion would surely
be the result; ability of the heart to force blood to the lungs would be
overcome and cause trouble.
A CASE OF BILIOUS FEVER.
Suppose we take a few diseases and submit them to
the crucial ordeal of reason, and see if we do, or can find any one of
the climatic fevers that appear with its full list of symptoms and have
no assistance from an irritated diaphragm. For example take a case
of common bilious fever of North America. It generally begins with
a tired and sore feeling of limbs and muscles, pain in spine, head, and
lumbar region. At this point of our inquiry we are left in an open
sea of mystery and conjecture as to cause. One says, "malaria," and
goes no farther, gives a name and stops. If you ask for the cause
of such torturous pain in head and back, with fever and vomiting, he will
tell you that the very best authorities agree that the cause is malaria,
with its peculiar diagnostic tendency to affect the brain, spine and stomach,
and administers quinine and leaves, thinking he has said and done all.
Reason would lead seekers for cause of the pain above
located to remember that all blood passes first as chyme up to heart and
lungs, directly through the diaphragm, conducted through the thoracic duct,
first to heart, thence to lungs, at the same time rivers of blood are pouring
into the heart from all of the system. Much of it very impure, from
diseased or stale blood. Much of the chyle is dead before it enters
the great thoracic duct and goes to the lungs without enough pure blood
to sustain life. Then disease appears.
As a cut-off the diaphragm, when dropped front and
down, and across the aorta and vena cava by a lowering of the ribs, on
both sides of the spine; it would be a complete pressure over coelic axis,
with liver supply, renal, pelvic, to a complete abdominal stoppage.
Then we have over-due blood for other parts to send off dead corpuscles
by asphyxia, with no hope that it can sustain life and health of the parts
for which it was designed. Thus we know that nature would not be
true to its own laws, if it would do good work with bad material.
A DEMAND ON THE NERVES.
Why not reason on the broad scale of known fact,
and give the "why" he or she has complete prostration when all systems
are wholly cut off from a chance to move and execute such duties as nature
has allotted to them. Motor nerves must drive all substances to,
and sensation must judge the supply and demand. Nutrition must be
in action all the time and keep all parts well supplied or a failure is
sure to appear. We must ever remember the demands of nature on the
lymphatics, liver and kidneys, that nerves work all the time or a confusion
for lack in their duties will mark a cripple in some function of. life
over which they preside.
DANGER OF COMPRESSION.
At this time we see by all systems of reason that
no delay in passage of food or blood, can be tolerated at the diaphragm,
because any irritation is bound to cause muscular contraction and impede
the natural flow of blood, first through the abdominal aorta, and even
to a temporary, partial or complete stoppage of arterial supply to the
abdomen. Or the vena cava may be so pressed as to completely stop
the return of venous blood from the stomach, kidneys, bowels and all other
organs, such as the lymphatics, pancreas, fascia, cellular membranes, nerve
centers, ganglionic and all systems of supply of organs of life found in
the abdomen. Thus by pressure, stricture or contraction to the passage
of blood can be stopped, either above or below the diaphragm, and be the
cause of blood being detained long enough to die from asphyxia, and be
left in the body of all organs below the diaphragm.
A CAUSE FOR DISEASE.
Thus you see a cause for Bright's disease of kidneys,
disease of womb, ovaries, jaundice, dysentery, leucorrhoea, painful monthlies,
spasms, dyspepsia, and on through the whole list of diseases now booked
as "causes unknown," and treated by the rule of "cut and try." We do know
that all blood for use of the whole system below the twelfth dorsal vertebra
does pass through the diaphragm, and all nerve supply, also passes through
the diaphragm and spinal column for limb and life. This being a known
fact, we have only to use reason to know that an unhealthy condition of
the diaphragm is bound to be followed by many diseases. A list of
questions arise at this point with the inquirers that must and can be answered
every time by reason only. The diaphragm is a musculo-fibrinous organ
and depends for blood and nerve supply above its own location, and that
supply must be given freely and pure for nerve and blood or we will have
a diseased organ to start with; then we may find a universal atrophy or
oedema, which would, besides its own deformity not be able to rise and
fall, to assist the lungs to mix air with blood to purify venous blood,
as it is carried to the lungs to throw off impurities and take on oxygen
previous to returning to the heart, to be sent off as nourishment for the
system. It is only in keeping with reason, that without a healthy
diaphragm both in its form and action, disease is bound to be the result.
A question from our side of the argument is: How can a carpenter build
a good. house out of rotten, twisted or warped wood? If he can, then
we can hope to be healthy with diseased blood, but if we must have good
material in building, then we should form our thoughts to suit the heads
of inspectors, and inspect the passage of blood through the diaphragm,
pleury, pericardium and the fascia, superficial, deep and universal.
Disease is just as liable to begin its work in the fascia and epithelium
as any other place. Thus the necessity of pure blood and healthy
fascia, because all functions are equally responsible for good and bad
WAS A MISTAKE MADE
IN THE CREATION?
At a given period of time the Lord said, "Let us
make man." After He had made him He examined him, and pronounced him good,
and not only good, but very good. Did He know what good was?
Had He the skill to be a competent judge? If He was perfectly competent
to judge skilled arts His approval of the work when done was the fiat of
mental competency backed by perfection. Since that architect and
skilled mechanic has finished man and given him dominion over the fowls
of the air, the beast of the field and fishes of the sea, hasn't that person,
being or superstructure proven to us that God, the creator of all things,
has armed him with strength, with the mind and machinery to direct and
execute? This being demonstrated and leaving us without a doubt as
to its perfection, are we not admonished by all that is good and great
to enter upon a minute examination
of all the parts belonging to this being; acquaint ourselves with their
uses and all the designs for which the whole being was created. If
we are honestly interested with the acquaintance of the forms and uses
of the parts in detail by close and thorough examination of the material,
its form and object of its form, from whence this substance is obtained;
how it is produced and sustained through life in kind and form. How
it is moved, where it gets its power, and for what object does it move?
A demand for a crucial examination of the skull, the heart, lungs, of the
chest, the stomach, liver and other organs of the abdomen is made.
The septum of the brain, the pericardium of the chest-the diaphragm of
the abdomen which is a dividing septum between the abdomen and chest.
In this examination we must know the reasons why any organs, vessel or
any other substance is located at a given place. We must run with
all the rivers of blood that travel through the system.
We must start our exploring boat with the aorta,
and float with this vital current; see the captain as he unloads supplies
for the diaphragm and all that is under it. We must follow him and
see what branch of this river will lead to a little or great toe, or to
the terminals of the whole foot. We must pass through the waters
of the dead sea by the way of the vena cava, and observe the boats loaded
with exhausted and worn out blood, as it is poured in and channeled back
to the heart, with all below the diaphragm. Carefully watch the emptying
of the vena azygos major and minor, with the veins of the arms and head
all being poured in from little or great rivers to the vena innominate
on their way to the great hospital of life and nourishment; whose quarter-master
is the heart; whose finishing mechanic is the lung. Having acquainted
ourselves with the forms and locations of
this great personality we are ready at this time after examination,
and found worthy and well qualified to enter into a higher class in which
we can obtain an acquaintance with the physiological workings separately
and conjoined of the whole being. At this place we become acquainted
with the hows and whys of the production of blood, bone and all elements
found in them, necessary to sustain sensation, motion, nutrition, voluntary
and involuntary action of the nerve system. The hows and whys of
the lymphatics, the life sustaining powers of the brain, heart, lungs,
and all the abdominal system, with their various actions and uses, from
the lowest cellular membrane to the highest organ of the body.
RESULT OF REMOVAL OF DIAPHRAGM.
When we consult the form of the cross-bar that divides
the body in two conjoined divisions and reason on its use, we arrive at
the fact that the heart and lungs must have ample space or room to suit
their actions while performing their functions. At this time a question
comes up: What effect would follow the removal of the fence between heart,
lungs and brain, above that dividing muscle, and the machinery that is
situated below said cross-bar? We see at a glance that we would meet
failure to the extent of the infringement on demanded room for normal work
of heart to deliver below lungs to prepare blood, and the brain to pass
nerve power to either engine above, and all organs below the diaphragm.
SUSTAINING LIFE PRINCIPLES.
The life of the living tree is with the bark and
superficial fascia which lies between the bark of the body of the tree,
its periostium. The remainder of the tree takes the position or place
of secreting. Its excretory system is first upwards from the surface
of the ground, and washes out frozen impurities in the spring, after which
it secretes and conveys to the ground through the trunk of the tree to
the roots which is like unto the placenta attached to mother earth, qualifying
all substances of constructing fiber and leaf, of that part of the tree
above the ground. Each year produces a new tree which is seen and
known by circular rings called annular growths. That growth which
was completed last year is now a stale being of the past and has no vital
action of itself. But like all stale beings its process is a life
of another order, and dependent upon the fascia for its life and cellular
action which lies under the bark, for its own existence as a living tree.
It can only act as a chemical laboratory and furnish crude material which
is taken up by the superficial fascia and conveyed up to the lungs, and
exchanges dead for living matter, to receive and return to all parts of
the tree, keeping up vital formation. With frost its vital process
ceases through the winter season until mother earth stimulates the placenta,
and starts the growth of a new being, which is developed and placed in
form on the old trunk. Thus you see everything of animal growth as
we would call them, is a new being, and becomes a part of the next being
or growth formed.
Should this form of vitality cease with the tree
another principle which we call stale life takes possession and constructs
another tree which is just the reverse of the living tree, and builds a
tree after its own power of formulation from the dead matter, to which
it imparts a principle of stale life, which life produces mushrooms, frogstools
and other peculiar forms of stale beings, from this form of growth.
Thus we are prepared to reason that blood when ligated
and retained in that condition of dead corpuscles, and no longer able to
support animal life, can form a zoophyte and all the forms peculiar to
the great law of association, as tumefactions of the lymphatics, pancreas,
liver, kidneys, uterus, with all the glandular system, be they lymphatics,
cellular, ganglia or any other parts of the body susceptible of such growths,
below the diaphragm. Thus we can account for tubercles of the abdomen
and all organs therein found.
LAW APPLICABLE TO OTHER
This same law is equally applicable to the heart,
lungs, the brain, tissues, glands, fascia and all substances capable of
receiving without the ability to excrete stale substances.
As oedema marks the first tardiness of fluids we
have the beginning step which will lead from miliary tuberculosis to the
largest known forms of tubercles, which is the effect of the active principles
of stale life or the life of dead matter.
POWER OF DIAPHRAGM.
At this point we will draw the attention of the reader
to the fact that the diaphragm can contract and supend the passage of blood
and produce all the stagnant changes from start to completed deadly tubercle.
Also the cancer, the wen, glandular thickening of neck, face, scalp, fascia
and all substances found above the diaphragm. In this stale life
we have a compass that will lead us as explorers from the North star, to
the South pole, the rising sun of reason, and the evening dews of eternity.
This diaphragm says: "By me you live and by me you die. I hold in
my hand the powers of life and death, acquaint now thyself with me and
be at ease."
The truth of the presentation of facts should be the principle
object of every person who takes his pen with a view to give the reasons why
certain witnesses' testimony are indispensable to establish supposable or known
truths. This being the case I have summoned before this court of inquiry
an important witness. He has now taken the oath to tell the truth, the
whole truth and nothing but the truth, of the case before this court.
His name is the Great Omentum. Mr. Omentum, state if you know of any reason
why or how by irritation from a misplacement of your body or any of its attachments
to or about the diaphragm, the spine, stomach or other places that could cause
irritation and thickening by congestion of your own body to such degree as to
impede the flow of arterial or venous blood, over whose position you occupy
much space from the diaphragm downward? State what effect a falling down
of the eleventh and twelfth ribs on both sides of the spine with their cartilaginous
points turned inward and down; if they should draw the diaphragm down and across
your body? What would be the effect on circulation of the blood, and other
fluids on the kidneys and other organs of the abdomen and pelvis? Would
it not be the foundation for destructive congestion, and abnormal growth?
State if you know if any such ligation would cause swelling by retention of
blood in the spleen, liver, kidneys or other organs of the abdomen and pelvis?
Would it be reasonable to suppose that you could perform your functions in office
with any irritating condition caused by prolapses of diaphragm? Would
not an irritation of your attachment to the diaphragm, spine or stomach be great
enough to impede the blood on its passage through the aorta to the abdomen,
or impede the flow of blood back and through the diaphragm? If so state
how and why?