History of Osteopathy

Early years:

Osteopathy was founded by an American doctor, Andrew Taylor Still, in 1874. Still was born in 1828 in Virginia USA. His Father was a Methodist minister, doctor and  farmer. Still followed his father and began training to become a doctor. His medical education was typical of the day and consisted of a type of apprenticeship with his father and some formal training. He did for a time attend the College of Physicians and Surgeons of Kansas City but his training was cut short when he left to enlist with the breakout of the American civil war. He was a strong supporter of Lincoln and the anti slavery cause.

Andrew Taylor Still

Andrew Taylor Still

After the civil war, where he achieved the rank of major, he returned to his medical studies and was eventually accepted as a physician in the state of Missouri. Still always felt a deep sense of futility with the medicine in use at  the time and was appalled at the toll of disease.  He practiced at a time before the full development of the germ theory of disease  and any form of antisepsis with medical practice consisting mainly  in the unscientific use of emetics, purges and other forms of drugs of dubious value .

Osteopathy begins:

A turning point in his medical career emerged when he lost 3 of his children to a meningitis epidemic. Armed only with the medical knowledge of his day Still could only sit helplessly by as they died. This intense anguish caused him to search relentlessly for a more effective basis for therapeutics. He was almost alone in recognising the futility of the then current practice of medicine and longed for a science of medicine that had a basic philosophy soundly founded on anatomical and physiological principles.

He began  an intense study of the human body especially the structure of the body. Still’s previous experience on the farm gave him an appreciation of how the structure of animals was related to their function. He therefore studied the structure of the human body in terms of how the frame of the body impacted on its function.  He noticed that disturbed relationships between bony articulations and muscles would disturb the blood and nerve supply not only near the affected area but distant from the site as well. He reasoned that disturbed blood and nerve supply to internal organs and other parts of the body would eventually allow abnormal conditions to become apparent and lead to disease. His research led him to appreciate the interconnectedness of the different body systems and saw how the musculoskeletal system affected and was affected by other systems  of the body such as the circulatory, respiratory, endocrine and nervous systems. He began to develop a comprehensive system of manipulations to the muscles, ligaments, bones and fascia to normalise these structures.

He began incorporating these new methods into his practice using manual methods to treat patients and largely stopped prescribing pills and potions. As his results continued to be positive his fame started to grow and people started coming from all over America to see this strange new healing method. He began to train his sons in his methods as the demands to see so many patients made it impossible for him to see everyone. Resulting from the enquiries of so many to learn his system he eventually began a school to train others in this new method he named Osteopathy. In keeping with his liberal values he allowed entry to women and blacks.

Still presented his theories to the medical establishment believing that medicine at the time had seriously neglected the role of the musculoskeletal system in diagnosis and treatment. Still was adamant that he was not trying to start a new school of medicine but to improve the practice of medicine and obstetrics. His was a philosophy emphasising the unity of the body and its natural healing capacity following structural integration and thought that anything useful in medicine used within this framework could be incorporated. Thus manipulation played a large part but he did not reject diet, effective medicines or surgery when needed. However his theories were rejected as too radical.

Still returned to his duties of teaching and treating and as the success of the system of Osteopathy grew the profession gradually developed further teaching institutions in other states.

The Osteopathic profession in America

modern Osteopath

American Osteopaths training in manual methods

In 1910 the Carnegie foundation in America commissioned a report by Abraham Flexner into the quality of medical education in the US.  At this time there was a plethora of colleges of varying quality producing many doctors of variable professional standards. Included with medical institutions which were called allopathic, there were colleges that taught naturopathy, homeopathy, phytotherapy, chiropractic and osteopathy. Following this report which was quite damming on the quality of education in many colleges, almost half of the medical schools and almost all the alternative colleges closed as they were unable to meet the minimum scientific requirements for medical training. A number of  Osteopathic colleges were able to meet these standards and so remained which ultimately led to the standardisation of medical and basic science curricular in the remaining Osteopathic and Medical schools.

The American Osteopathic profession emerged as a parallel profession to allopathic medicine with their own teaching institutions and hospitals and produced physicians with the same license to practice as allopathic physicians. As such they are qualified in all aspects of medicine and can prescribe drugs, perform surgery and write out death certificates. The difference is that they integrate manipulation and the philosophy of body unity into the practice of medicine. Thus if you consulted an Osteopathic physician in America with, for example, a lung infection, you would be prescribed the appropriate antibiotic and the doctor would also employ manipulative techniques around the and rib cage and other areas to improve the function of the lungs. As at 2012 there were 82,500 Osteopathic Physicians in the USA.

Osteopathy outside the U.S.A

Osteopathy spread to England and Europe but developed as a limited licence or non medical profession. Osteopaths therefore did not practice with a medical licence but emphasised manipulation and the concepts of body unity while still adhering to a comprehensive medical and basic science curricular.

Osteopathy in Australia  has been practiced for 100 years. However before the late 1980’s, when university training started for Osteopathy, the number of practicing Osteopaths were small. They mainly came as immigrants from Europe or America or were trained locally at a few small private colleges.  Today osteopathy has grown as a recognized allied health primary care profession with a combination of traditional methods and modern scientific philosophies. It is currently one of the fastest growing health professions.

Still’s Legacy:

Still’s treatment philosophy and methods have been developed and modified since its original inception however the principles that Still had established are being daily conformed by contemporary osteopathic and medical research. His perspective was to see the functional unity of the body and the interrelationship of the various systems and parts, an approach which was considered radical in his time. Today such ideas are less radical and are more generally accepted.