Ernest Eckford Tucker
Principles of Osteopathy
A brief summary of the principles of Osteopathy
so far as they relate to the matter to be discussed in this book is a fitting
introduction to it.
Osteopathy rests on a very sure foundation.
Its philosophy rests on axioms; its practice on facts; its profession and
its history on success.
The axioms on which its philosophy is founded are:
I. Everything composed of mechanical parts is subject
to disorder among those parts.
From this axiom there is no appeal. There is
no exception to it. The solar system is not an exception, the eye
of the beetle is not an exception, and the human body is not an exception.
A corollary of this axiom is that the greater the
number of parts, the more frequent should be disorder or lesion
among them; and there are a great many different parts to the human body.
II. If anything depends on the order, then that thing
will be deranged by the disorder.
In the human body, function and health depend on
the order; and disease arises from the disorder.
There is no appeal from this axiom, for the laws
of mechanics are fundamental wherever they apply.
These are two fundamental axioms on which the science
is based. But let us go further with the matter. The human
body is in all respects subject to the operation of law. This is
certainly axiomatic. Where law does not operate logic is impossible.
If there be any parts not within the scope of law, then on those parts
may we experiment. If all parts are subject to law, then the only
experimenting that is justified it the experimenting to discover those
laws; and this experimenting should be performed on animals, not on human
beings. The only specific remedies that are possible are the specific
laws that are violated.
But if all parts of the human body are subject to
the operation of law, then it follows as an axiom that the only possible
cure for disease is the removal of causes; for to make any other attempt
is to try to suspend the operation of law.
Now there are only three possible kinds of causes
of disease as there are only three possible causes for bad functioning
in anything. They are causes that relate to the mechanism, those
that relate to the operation of it, and those that relate to the source
of it. In the human body, they are mechanical or structural disorder;
functional strain or exhaustion; and hereditary weakness. Every incidental
cause of disease must come under one of these heads. (It is possible
to define them all as one—as structural, reckoning intracellular disorders
as structural, though microscopic; but we preserve the distinction for
Of these three, heredity is not a cause of disease,
but of only the weakness that allows disease. Functional strain is
sometimes fundamental as a cause, sometimes secondary. If the strain
exceeds the total strength given by normal heredity, then is it a fundamental
cause of disease; if, however, it exceeds merely the existence of those
facts ten men or even three men cannot possibly be mistaken.
There have been 10,000 men who bore testimony to the osteopathic facts.
These facts are discovered in each individual case,
and treatment is applied to them as found. Each case contains its
own evidence, and correction is directed to that evidence, not to any general
formula of description, which may or may not apply in the individual case.
The profession itself grew up on a basis of success.
Things do not belong wrong; when found wrong they were corrected—no other
reason or excuse was necessary. But this was followed by cure.
From the very first inadvertent experiment made by Dr. Still, the policy
of correcting disorders was followed by good results, and was pursued only
and solely for that reason. Other men seeing the good results that
followed this policy insisted on being trained in it. From this beginning
the school arose, and the profession was organized. There is no appeal
from success. Things that succeed prove themselves true in relation
with every law known and unknown that applies to them.
The success of osteopathy is not absolute.
It does not acclaim to be the final revelation in the matter of healing.
It believes itself to be absolutely fundamental, however, a necessary basis
for whatever else of good may be found in the healing art; and to be unshakable
in principle and in logic. without vanity for itself or antagonism for
others, but in a spirit of impersonal estimate, it sees itself as a real
science of healing—i.e., the first; for surgery abandons the question of
cure, and removes—saves, but does not cure; medicine counteracts. Stimulates
and sustains, and cares for; but neither these nor any other science except
osteopathy alone bases its practice solely on the principle of removing
Mathematics is an absolute science, in theory.
In the application thereof to individual problems it is no stronger than
the technic of the person so applying it. The same thing is true
of Osteopathy. The practical reality of the science is in its technic.
That every physician’s technic is “different,” is
his own individual development, is well known. The only true contribution
to the subject therefore is along the lines of conception of lesions, and
the principles of technic, though much may be hoped for from merely comparison
of the technical development of others. Details of technic are here
given to illustrate the principles that are set forth. There is no
though, as there is no possibility of exhaustive or complete presentation
of such a subject.
Neither description nor illustration can convey a
proper concept of any individual technic. The sooner we abandon that
effort the better. Individual instruction, with supervision and correction
to insure the carrying out of the individual’s conception of his technic
is the only practical method, certainly is the ideal method.
Description, however, is necessary to lead to a scientific
development of the subject, a discussion of dangerous and faulty methods
and a definition of principles of technic.
In applying these principles to individual cases,
that is, in cultivating his individual technic, the physician must consider
the feelings of the patient. That technic is best which makes the
most successful compromise between pleasing the patient and promptly correcting
the lesions. The latter only is our problem here, and our purpose
is to develop as clear a mental picture of the mechanics and the principle
of technic as possible. The matter of adjusting this to the susceptibilities
of patients is the personal problem of the operator.
For a better understanding of the nature of lesions
and the mechanics of reduction, some understanding of anatomy from the
osteopathic point of view is desirable. In the rest of this preface
a summary of the important points that are brought out here and there in
the text is brought together. This subject might be called rational
anatomy as distinguished from descriptive anatomy.
Bones bear always pressure. Bone will form
automatically from pressure, and adapts itself automatically to the pressure
that bears upon it. The shape of every minutest bone in the body
therefore is an expression of the forces of pressure acting on it.
For illustration, the sacrum, composed of the five
vertebrae included between the iliac, has become solidified into one bone
and greatly enlarged from the pressure exerted by those iliac. It
is curved because as the body bends the great erector spinae muscle draws
at different angles. The tension of this great muscle is opposed
by the great sciatic ligament and other ligaments and is transformed by
them into pressure against the sacrum in line with its axis.
The rounded skull sustains pressure from muscles,
the occipito-frontalis and the temporal muscles, but chiefly it sustains
atmospheric pressure; as in fact do all bones. (In some birds, where
there is great and rapid change in this pressure as the bird rises and
descends in flight, the bones are hollow and communicate with the air.)
All muscles are so attached as to bring pressure
on the bones they move. Muscle is attached in reality to periosteum,
which encircles the bone, so as to bring pressure on its opposite side.
All joints therefore bear pressure. Nature
does not endure tension on joints. Muscles are relayed across joints,
criss-crossed as it were, bringing always pressure to bear on them.
This pressure is always perpendicular to the face
of the joint. For if it were not the joint would simply slide to
the limit of its motion in the direction of the diagonal pressure, and
An expression of this simple law is seen in the fact
that joints on the same bone are always at right angles to each other.
The shoulder faces inward, the elbow faces forward. But it is very
conspicuously evident in the vertebrae and ribs, where the joints are close
together. The reason is very easily seen. Given any one joint,
motion is transmitted, which means that pressure is transmitted, parallel
to the face of the joint. All vertical pressure is taken up by the
opposing face, and the parallel pressure or motion is transmitted.
A second joint therefore will have its face perpendicular to the first;
and a third joint will be perpendicular to both of the other two, like
the corner of a box. If there is a fourth joint, it is a cartilaginous
joint, like the cartilages of the ribs or the intervertebral discs;
and is parallel to the line of intersection of the planes of two of the
In the vertebrae, the facets for the ribs are at
right angles to each other and to the surfaces of the articular processes;
reckoning the latter as one joint; while the muscles in the bone they move
is brought to a focus and is tendinous.) For instance, the ligaments
of the spinous processes do not run vertically from one to the other, but
converge toward the articular processes, radially to the vertical motion
of each spinous process.
Where ligament is stretched as the vertebra moves
normally, it is of the yellow elastic variety; as in the ligamentum nucha
and the posterior longitudinal ligament of the spine.
This radial arrangement of ligaments makes it possible
to exceed the normal range of motion with slight stretching of the fibres
of the ligament; it helps to maintain the lesion when an angular position
has been assumed in lesion; and it gives rise to the popping sound when
such lesion is corrected.
A ligament which is radial to one motion of a vertebra
acts as a restraining force in motion of another character, and thus acts
also to change the direction of the motion—to produce “secondary” motions.
This fact assumes some importance in the following study of motions and
The bone and muscle arrangements of the body are
all levers, of great variety and of wonderful symmetry and sequence.
Of these the joints are the fulcra; the part between the joint and the
attachment of muscle is the power arm, the rest is the work arm; the muscle
supplies the power. Where ligament acts as a restraining force it
becomes part of the fulcrum, producing a double fulcrum with shifting of
the axis of motion.
These leverages must be used to get control of parts in lesion.