​" History of Osteopathy" Peter B Wagner D.O., Clinical Associate Professor at the East Carolina Heart Institute. April 11th 2011

Based upon a partial transcription with added personal notes in italics (Rohan iswariah D.O.,)

Youtube: https://bit.ly/2Qup8Oq

Laupus Library`s : Medical History Interest Group

Also see: Andrew Taylor Still University [4]

" ...I was probably the last person they asked, they probably asked a dozen people before me to do this talk..... I claim to be a third generation D.O. " (Peter B Wagner D.O.)

" Osteopathic medicine, I often say, is the best kept secret in America. There were lots of D.Os in the Philadelphia area....in North Carolina it was much less well known however...."

" Osteopathy was born on the frontier, Andrew Taylor Still was the founder of Osteopathy, he was an M.D, a Physician, an Author, an Inventor and a Politician, a renaissance man frontier style". (August 6, 1828- December 12, 1917).

" To give a little flavour of the frontier in those days, ATS great grandfather was was killed by a Shaunee war party in July 14th 1786. His great grandmother was also captured and killed along with several of her children, two survived Mary and James. ATS father was Dr Abram Still born in 1797 NC moved to Tennessee was ordained as a preacher in the Methodist church, a fire and brimstone sort of guy who married Martha Moore."

Abram was an ardent abolitionist (slavery) as was ATS himself.

" ATS grew up on a farm..... and attended many formal schools. ATS quote " My frontier experience was valuable to me in more ways than I can ever tell....I had almost perfected knowledge from the great book of nature"."

He married Mary Vaughn in 1849, they had three children, two died young, Mary died in 1859, a devastating blow, which took years to get over. He remarried in 1860 Mary Turner and they had a bunch of children.

"ATS trained initially as an apprentice, later attended College of Physicians and Surgeons in Kansas City, MO. He was an intense student of anatomy both from text books and nature. This was the  
" Jacksonian era"- a time that encouraged independent thought and the development of new disciplines to improve the lot of mankind."

"Everybody was looking for a better way to do things; Between 1852-3 (ATS) was a scout surgeon under Gen. John C. Fremont doing surgery. He served in the legislature in Kansas 1857-8. He was well known in the area for his politics (anti-slavery) and his medical skills.
He founded Baker University in 1858. "

During the Civil War he served as a surgeon rising to the rank of Major. He suffered some injuries 
During this time he began to lose faith in mainstream medicine, he (they) faced epidemics of cholera, malaria, pneumonia, diphtheria, smallpox, tuberculosis. Medication at the time was quite crude with heroic remedies which were often harmful such as arsenic, castor oil, whiskey [sic] and opium. Many injuries were treated with amputation and infection was poorly understood. There was routine use of blood letting, emesis and sedation with narcotics. Only maggots, chloroform and ether for anaesthesia, and opiates for pain seemed to have any effectiveness. Leeches are still used today in modern medicine, particularly in plastic and reconstructive surgery. Hirudo medicinalis (European medicinal leech ); the bite causes prolonged and localised bleeding giving grafts time to re-establish there own circulation. [1]  

Casuality figures from Kansas regiments reflected the national medical crisis. Circa 1000 soldiers were killed in battle and 2100 died of disease. In the Union army 286 surgeons died of which 231 died of disease. Following the war Still lost three children to spinal meningitis and one to pneumonia in just one year.

Still believed that the conventional medical system (at the time) lacked credible efficacy, was morally corrupt, and treated effects rather than causes of disease. He began to see in that part of the states of Missouri and Kansas where the doctors (at that time) were shut out, the children did not die.

He developed the belief that everything that was necessary to sustain human life was already present within the human body, that the body has an innate ability to heal itself and he was looking for non-medicinal and non-surgical avenues to enhance the body`s innate capacities to heal itself.

He invented the name "osteopathy" by blending two Greek roots osteon- for bone and -pathos for suffering. 

He appreciated the true meaning of Hippocrates idiom " it is our natures that are the physicians of our disease"

Sir William Osler, frequently described as the Father of Modern Medicine and founder of the History of Medicine Society [2][3] said "Medicine should begin with the patient, continue with the patient and end with the patient." Also " One of the first duties of the physician is to educate the masses not to take medicine. " 

Still was mechanically minded and held several patents, and held that the body was a highly complex machine which, like any other machine, required proper alignment and lubrication for optimal functioning. He focused on removing "mechanical blockages" to the free flow of fluids (blood, lymphatic fluid, CSF) and nerve impulses and this was the key to self-regulation and self-healing processes of the body. Still first proposed these concepts in 1874.

" To find health should be the object of the doctor. Anyone can find disease." (ATS 1874)
" My father was a progressive farmer, and was always ready to lay aside an old plough if he could replace it with one better contructed for its work. All through life, I have ever been ready to buy a better plough. " A.T.Still

After recovering form injuries sustained in the Civil War, he finall settled in Kirksville, MO (1889) established an infirmary and was quite successful.- The railroad scheduled additional trains to handle the large volume of patients, At the end of th 19th century there were multiple schools of healing developing, chiropractic, homeopathy, naturopathy, with a lot of competition and indeed mistrust of new ideas, lots of charlatans running around making it hard for the average person to differentiate. 
This was frontier medicine not "big city" medicine. Promoting these concepts and therefore acceptance of Still`s concepts was limited in the East.

The first school opened in 1892 Kirksville, MO and is still in existence as the A.T.Still University- Kirksville College of Osteopathic Medicine, the American School of Osteopathy. The first class consisted of 21 students, men and women, no discrimination, including three of Still`s sons and one daughter. The faculty consisted of two, Still and William Smith, MD, DO, who was a Medical Doctor trained at the Royal College of Physicians and Surgeons of Edingburgh, Scotland. He was visting the area to sell medical books and began to hear stories of Still from physicians in the town who said that he was hurting their business. Yes they were concerned about their businesses ! Hmmm !

The physicians used many derogatory terms to describe Still and his theories in order to damage him one suspects. Despite or maybe because of this, Dr Smith became interested and intrigued with this revolutionary system of therapeutics, so he agreed to teach anatomy if Still would instruct him in osteopathy.

William Smith M.., D.O. Became the first graduate of the American School of Osteopathy.

Still had many students that started their own schools after qualifying. The American School of Osteopathy had grown to 30,000 square feet by January 1897, where 14 faculty members taught 280 students from 24 states and two Canadian provinces.

The building also housed one of the earliest x-ray machines west of the Mississippi River.

By 1897 the American Association for the Advancement of Osteopathy was organised, the forerunnerof the AOA (American Osteopathic Association).

The first president Daniel B. McAuley, D.O. Spoke about the organization [sic]

" The reasons for the organization are many, are obvious, are strong; and personal protection is the least of these. No; the members of this organization [sic] have laid upon them a heavier responsibility, a greater duty, than the so-called "first law of nature", self-preservation. The primary objects of the organization [sic] are, in the broadest sense, to work toward and attain all things that will truly tend to the "advancement of Osteopathy", and the rounding of it into its destined proportions as the eternal truth and vital principle of therapeutic science. "

Clearly a passion existed and by 1898 several schools had opened and by 1903 inspections were established to assure the highest professional standards. Osteopathy, however, was developed on the frontier not from the ivory towers of medicine from the east, thus osteopathy began to be repressed. 

The theories were not well received and during the first half of the 20th century the AMA (American Medical Association) labelled Osteopathy as a cult and therfore Osteopaths as cultists.

Even Baker University that Still had helped found restricted him from lecturing. Interestingly Mark Twain ( American writer, humorist [sic], publisher and lecturer) a proponent of Osteopathic Medicine said " To ask a doctor`s opinion of osteopathy is equivalent to going to Satan for information about Christianity." (1901). Much has changed since those days in medicine, osteopathy and the collaboration between professionals for the benefit of patients !?

Mark Twain believed that manipulative treatments helped alleviate the symptoms of his daughter`s epilepsy and his own chronic bronchitis.

In 1938, the Federal Compensation Law was amended to include D.O.s as physicians. In May 1961 in California the College of Osteopathic Physicians and Surgeons (COPS) was converted to an allopathic institution, which was quite damaging to the osteopathic profession as conversion degrees were offered, at a cost, which effectively allowed 85% of DOs to "trade-in" their DO degrees for MD degrees.

In 1962 Proposition 22 passed-abolishing the osteopathic licensing board. These MD degrees were not recognised outside the state.

This backfired as it turned into a catalyst for obtaining full licensure in all 50 states, equivilating osteopathic and allopathic medicine. 

By 1973, all 50 states and the District of Columbia granted D.O.s full practice rights. Simultaneously, The AOA and the osteopathic physicians in California worked to overturn Proposition 22. In 1974, the California Supreme Court declared the policy as unconstitutional and a new osteopathic board was established.

In 1977, the College of Osteopathic Medicine of the Pacific was opened.

Back in 1952 the AOA was recognised as the accrediting body for osteopathic medical education by the U.S. Department of Health, Education and Welfare and in 1967 the AOA was recognised by the National Commission on Accrediting for all facets of osteopathic medical education.

This Federal recognition allowed for many more osteopaths to be trained through the late 70s and 80s. D.O.s were made eligible for military commissions in the mid 1950s.

Today D.O.s serve in all branches of the military, Lt General Ronald R. Blanck, D.O., MC (ret.) was Former Surgeon General of the Army and the Commanding General of the United States Army Medical Command.

So what is osteopathy ? Osteopathic Philosophy ?

Well Structure and Function are closely related. You cannot separate one from the other.
Form determines function. Function determines form. 

Health emerges when form and function are perfectly expressed. 

No single part exists independent(ly) of the whole. When even a (seemingly) small part of the body dysfunctions, the entire organism is (can be)affected.

There is within each of us an inherent wisdom; a wise all knowing restorative force, an intelligence within every cell that keeps the body well. When a state of discord arises, this healing force acts to restore balance and harmony. 

The Rule of the Artery is Supreme. When blood and lymphatics flow freely, the tissues can perform their physiologic functions without impedance.

This needs application. Osteopathic Medicine at work- Influenza Pandemic 1918, Osteopathic hospitals had a lower motality rate than allopathic hospitals.

One of the consequences of influenza was pneumonia, and as this was pre-antibiotics treatment, different treatments were required, many of which are mainstream today such as;

Lymphatic pump techniques including chest percussion, physical therapy. In obstetrics, morning sickness was relieved by manipulation in many cases. And of course back pain is very common during pregnancy and indeed after giving birth (post-partum) as a result of postural changes allied with placental secretions that cause relaxing of the ligaments to allow for pelvic movement and sacral nutation during childbirth. This ligamentous laxity causes some instability and together with loading of both a mechanical and a respiratory nature causes cramping in the case of muscles that can cause a great deal of pain.

Holistic Medicine is an Osteopathic concept as is Wellness.

A lot of what was considered Osteopathic medicine is now mainstream medicine (not always attributed to Osteopathic Philosophy however). Popular concepts today were espoused in Osteopathic teaching 100 years ago.

The founder of Chiropractic, Daniel David Palmer (7th March 1845- 20th October 1913) was a contemporary of A.T.Still and it is possible that they knew each other and came up with similar concepts at the same time. Chiropractics (Chiropractors) believed " A subluxated vertebra... is the cause of 95 percent of all diseases... The other five percent is caused by displaced joints other than those of the vertebral column"

Considered a very bold statement (by Peter B Wagner D.O.)

Four Osteopathic Schools have been in operation for over 100 years in the USA.

Chicago College of Osteopathic Medicine 1900
Des Moines University of Osteopathic Medicine 1905
Kirksville College of Osteopathic Medicine 1892
Philadelphia College of Osteopathic Medicine 1898

The American Osteopathic Association1s Commission on Osteopathic College Accreditation (COCA) currently accredits 26 colleges of osteopathic medicine with 32 locations.

There are 4000 new graduates each year and 63,000 licensed D.O.`s in the United States (as of 2011)

Where is Osteopathy Today ?

To better convey to the public that US-trained DOs are fully licensed physicians, the term osteopathic medicine has replaced the term osteopathy in most uses and the term osteopathic physician has replaced the term osteopath.

Osteopathy is taught in several foreign countries including Canada and the UK, but only in the US are Osteopathic schools training complete physicians.

Where is Osteopathy Going ?

The way reimbursement is or works in the US for a lot of physicians means that many osteopaths are turning away from osteopathic techniques as they take time. You (one) can`t do an osteopathic treatment in ten minutes. A proper examination is required and treatment with the essential hands-on approach is a concept insurance companies have always had a problem with. For the next generation a lot of these techniques (informed by osteopathic philosophy, so not merely technique driven, as osteopathy is not a prescribed set of techniques will/could be lost and only in the central osteopathic schools will treatment be possible.

[1] Leech Guideline-Mid Essex Hospital Services NHS Trust-www.meht.nhs.uk (10/06/2016)
[2] en.wikipedia.org/wiki/William_Osler
[3] www.rsm.ac.uk/sections/sections-and-networks-list/history-of-medicine-society/
[4] https://www.atsu.edu/museum-of-osteopathic-medicine/exhibits-collections

Rohan D Iswariah D.O.
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