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History / Background of Osteopathy

A) MEDICINE IN 19th CENTURY

"Indeed, in medicine, from antiquity to the late 19th century, the means of therapeutic action have made little progress. The use of magical fancy or unusual requirements has continued until relatively recently. The use of drugs mostly of plant origin, was the result of a poor yet empirical scientific means. On the eve of the discovery of divine aspirin and the development of the syringe injection, sick in the time of Napoleon III, were treated little better than those of the Middle Ages. Even if the active ingredients of medicinal plants began to be extracted and prepared in the form of alkaloids and glycosides from the early 19th century, pharmacology and pharmaco dynamic innovated 50 years earlier, only grew, as from 1860. Modern therapeutics is born shortly before 1900 thanks to economic favourable circumstances: the development of chemical methods of analysis and synthesis and manufacture of drugs of mass consumption by industrial processes. The rest is history in 50 years, the emergence of cardio tonics, sedatives, hormonal therapy replacement therapy, antibiotics, anticoagulants, vitamins, etc ...

So it was in this pivotal period, the starting point of modern medicine rich in promising discoveries, but poor treatment options that Dr. Andrew Taylor Still practiced medicine in the United States of America.


B) ANDREW TAYLOR STILL

Dr. Andrew Taylor Still was born in Virginia in 1828. Son of a Methodist pastor, the Rev. Abraham Still; he was, very early in contact with religion, nature and medicine.

Indeed, in addition to its religious activities, the Rev. Abraham Still was also a farmer and gave faithful care when they were sick. His father was sent as pastor in a small town in northeast Missouri, near an Indian reservation. The family moved, and that is where the young Still spend the rest of his childhood and adolescence. Andrew Still was therefore a strong boy, accustomed to farm work and pioneer life. He was a good hunter says his brother Tom and he brought most of the game for the family. He loved to spend hours observing nature. So very soon he became interested in the mechanism of life. In anatomy, for example, as he dissected some animals back from the hunt and collected their bones.
Still writing elsewhere in one of his books: "Long before studying anatomy in the books, I had studied in the great book of nature, I was already familiar with the muscles, nerves, vessels and the bones of squirrels that had dissected before learning their names in the medical books.”

From a young age too, Andrew Still attended his father in the practice of medicine. Medicine at the time, and especially the United States of America, was far from having attained the degree of specialization that it has reached today.
In fact, Pastor Still cared for the common ailments of a population composed largely of farmers and Indians accustomed to hard physical work. He certainly used herbal pharmacopoeia and practiced minor surgery and manipulation. Dr Still writing in one of his books that his father routinely reduced shoulder dislocations. He surely learned from his father’s reduction techniques, and joint manipulation techniques of bone-setter, in a region where the stiff neck, low back pain, shoulder dislocations and other such problems, given the lifestyle of the pioneers who inhabited the region, for much of the pathology.

So in this atmosphere bathed in religion and medicine, in contact with the hard life of pioneers and Indians that he has surely learned, bordering the American Midwest, the young Andrew Still developed the themes that will guide his life as a man.

b) Adult Still A.T

Andrew M. Still Married in 1849, when he was 21 years. He settled in the region of Macon, Missouri, where for many years it will be a farmer and doctor at once. Then gradually, the medicine will be the main focus of his life.

His training in the field is initially very empirical. it is mainly the result of what his father taught him on the ground, and of his readings and personal observations.

It should be noted that in the United States of America of that time, medical education was not very standardized. Most doctors were trained as apprentices by a colleague, completed their training by their reading, and thus obtain a license to exercise medicine in their state. This was the case of Andrew Still in his early life.

Nevertheless, there were official schools of medicine. It is in one of them, the school of medicine and surgery in Kansas City, Missouri, Dr Still in the early 1860s came to do his studies. He thus acquires a comprehensive training in medicine and surgery of his time.

Still that was anti-slavery, served as surgeon in the Union Army during the Civil War. He had the rank of Major. During this period he has the opportunity to engage in war surgery in the most rudimentary conditions.

In 1864, an outbreak of cerebrospinal meningitis occurs in Kansas. it will carry three of his children. Terribly affected by these deaths and deeply convinced that the therapeutic time was often ineffective, and even more dangerous than the disease it was meant to treat, this directed Dr Still towards what he called a new track, which would give birth, ten years later, to osteopathy.

c) Dr Still and osteopathy

We saw this era was rich in fruitful discoveries in many fields of medicine, but poor therapeutic solutions.

He was certainly aware of many of these discoveries. Indeed, he endowed the school of osteopathy in Kirksville he founded in 1895, with an X-ray equipment.
 

This other way, we shall see, seems in fact to revive the ancient tradition of Hippocratic medicine. Very religious, Dr Still believed that God had created man with all his medicines. If the man was capable of falling ill, he surely must have in himself the resources of his treatment: Joining Hippocrates father of medicine, he gave precedence to the patient and his environment.

Dr Still is in the same lineage. Thanks to his training as a surgeon and his many years spent dissecting, he had a very precise knowledge of anatomy. His sense of touch was so developed that they say could recognize the touch even the deepest structures of the body.

He gave much importance to hygiene and nutrition. To him a doctor had to keep people in shape to avoid having to treat the disease once declared. Concept found in Chinese medicine.

 He already foresaw the role of blood in the phenomena of immunity so that nothing had yet been demonstrated in this regard. All these topics, behind which loomed the great ideas of preventive medicine and even immunology, would give birth to osteopathy.

June 1874, Dr. Andrew Taylor Still officially informs his colleagues re: the results of his research. He appoints his osteopathic diagnostic and therapeutic system, Greek, bone, and pathos, pathology.

In 1892, Dr Still received permission to found the American School of Osteopathy in Kirksville, Missouri, which will be both a care center and teaching of osteopathy, the first of its kind.

Osteopathy takes a considerable development, and several schools are created in the United States and Europe.

d) Evolution of osteopathy in the United States

After the war of 14-18, many students enroll in schools of osteopathy due to lack of school places in orthodox medicine. This influx of students has two significant consequences for schools of osteopathic medicine in general.

On the one hand, a significant financial contribution which allows them to expand and raise the level of their education through investments in equipment, library, etc ...

On the other hand, most of these new students came to study medicine and are not especially motivated by osteopathy. Also, about 1935, both external and internal pressure causes the osteopathic schools to model their program on the medical school.

The movement is strengthened after the Second World War, many veterans, who received scholarships for a period equal to their time of service. In 1945, doctors of osteopathy got the same rights as medical doctors, under the leadership of President Roosevelt who was successfully treated by an osteopath.

As a result, most schools, and therefore osteopaths, are moving towards a standard orthodox medicine.

Finally, the osteopathic schools are integrated with orthodox medical education system.

And the College of Medicine and Surgery 0steopathic Los Angeles becomes a school of orthodox medicine in 1900, with retroactive effect to conversion of the degree of doctor of osteopathy (DO) degree of Doctor of Medicine (MD). Both degrees have the same value is actually the United States.


Dr. Paul Elie Cohen, "Report of an internship in Internal Medicine General (IMG) at the British School of Osteopathy (BSO)"
Universite Pierre et Marie Curie (Paris 6) - Faculty of Medicine Pitie-Salpetriere, 1989. pp 5-23

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