PREFACE

OSTEOPATHY AND TRUTH. A. T. Still, M. D., D. O.

HISTORY OF OSTEOPATHY. Asa Willard, D. O.

HOW I CAME TO ORIGINATE OSTEOPATHY. A. T. Still, M.D.,D.O.

WHAT OSTEOPATHY IS. Carl P. McConnell, D. O.

THE POINT OF DEPARTURE BETWEEN OSTEOPATHY AND MEDICINE. E. E. Bucker, D. O.

DISEASE FROM AN OSTEOPATHIC VIEWPOINT, M. F. HULETT. B. S., D. O.

WHAT OSTEOPATHIC LESIONS ARE. G. M. LAUGHLIN, M.S.D., D.O.

MANNER OF TREATMENT. G. V. WEBSTER, D.O.

A DIFFERENTIATION:
    Differences Between Osteopathy and Massage, A. R. Still, M.D., D.O.
    An Illulstration. Asa Willard, D.O.

SCIENTIFIC PROOFS OF OSTEOPATHY. G. V. Webster, D.O.

A SUMMARY OF OSTEOPATHIC RESEARCH WORK. J. DEASON, M.S., D.O.

THE OSTEOPATHIC EDUCATION:
    Osteopathy, A Distinct School. C.P. McConnell,D.O.
    Osteopathic Teaching. C. C. Trall, D.O.
    The Osteopathic Curriculum, R. H. Williams, D.O.

APPLICATION OF OSTEOPATHIC PRINCIPLES. G.V. Webster, D.O.
    Diseases of the Nervous System
    Diseases of the Digestive System
    Diseases of the Respiratory System
    Diseases of the Circulatory System
    Diseases of the Kidney
    Diseases of the Pelvic Organs
    Diseases of the Skin
    Acute Infectious Diseases
    Diseases of the Eye and Ear
    Constitutional Diseases

THE GROWTH OF OSTEOPATHY. A. G. Hildreth, D.O.

OSTEOPATHIC STATISTICS. G. V. Webster, D.O.

OSTEOPATHIC INSTITUTIONS. C. M. T. Hulett, D.O.

OSTEOPATHY AND SURGERY. Geo. A. Still, M.S., M.D., D.O.

HOW OSTEOPATHY TREATS THE BLOOD. C. P. McConnell, D.O.

OSTEOPATHY AND THE GERM THEORY. R. E. Hamilton, M.Ph,,D.O.

THE VALUE OF OSTEOPATHY TO THE CHILD. Mina Abbott Robinson, D. O.

WOMAN AND OSTEOPATHY. Roberta Wimer-Ford, D.O.

OSTEOPATHY A PREVENTIVE OF DISEASE. G.V.Webster, D.O.

A DELICATE QUESTION—LIFE

THE RESULTS OF OSTEOPATHIC PRACTICE. G. V.Webster,D.O.

OSTEOPATHY IN THE FUTURE. Russell Duane

DR. ANDREW TAYLOR STILL

OSTEOPATHIC HOSPITAL AND SCHOOL AT KIRKSVILLE, MO.

THE MASSACHUSETTS AND PHILADELPHIA COLLEGES

THE CHICAGO COLLEGE OF OSTEOPATHY
 
COTTAGE IN WHICH OSTEOPATHY WAS FIRST TAUGHT

STILL-HILDRETH SANITORIUM

OSTEOPATHIC COLLEGES AT DES MOINES AND LOS ANGELES

THE "OLD DOCTOR" STUDYING THE FEMUR

The purpose of this volume is to reflect the position occupied by Osteopathy as a system of therapy. Osteopathy is the name applied to that school of practice of the healing art which has developed as the result of the theories and discoveries of Dr. Andrew Taylor Still. The two basic theories, first propounded by Dr. Still, and forming the tenets upon which the osteopathic school rests are: first, the theory of the mechanical lesion as a cause of disease; and, second, the theory that the normal chemical body is practically immune.

Osteopathy has so demonstrated its usefulness to mankind that a spirit of inquiry has been aroused as to just what Osteopathy is, what it has done and what may be expected of it. With a view to preparing a volume which may in a measure provide the information desired, these pages have been arranged.

Little originality of text has been attempted, but, rather, in the review of the osteopathic literature that has appeared from time to time in the professional and other publications, an effort has been made to select such articles as seem appropriate for this volume. These, in some instances rearranged and condensed to omit technicalities, have been compiled in a more or less logical order, giving the history of Osteopathy, its development as a science, an exposition of its theories, some of its practical workings and something concerning its founder, Dr. Andrew Taylor Still.

Acknowledgment is here made of the courtesy of the several publishers for the permission granted to select from their pages such articles and quotations as appear in this book. Where possible, credit has been given both to author and to publication.

I am indebted to Dr. J. Deason, for contributing an original chapter; to Drs. Asa Willard, Carl P. McConnell, Geo. A. Still, R. H. Williams and R. E. Hamilton for revision of chapters; to Drs. Mina Abbott Robinson, Roberta Wimer-Ford and E. E. Tucker for revision of articles, to Drs. G. W. Riley, A. G. Hildreth and J. Deason for statistical information, and to many other professional friends for valuable aid and suggestions relative to the revision.

CARTHAGE, N. Y. G. V. WEBSTER

June 1, 1919

While for years I fought the battles of Osteopathy alone, meeting great opposition and vilification, I knew I had the truth and that the truth was immortal and that some day the principles of Osteopathy would be hailed with gladness throughout the earth. The principles are in harmony with the great laws of God as seen in Nature. Osteopathy deals with the body as a perfect machine, which, if kept in proper adjustment, nourished and cared for, will run smoothly into ripe and useful old age. As long as the human machine is in order, like the locomotive or any other mechanical product, it will perform the function which it should. When every part of the machine is correctly adjusted and in perfect harmony, health will hold dominion over the human organism by laws as natural and immutable as the laws of gravity. Every living organism has within it the power to manufacture and prepare all chemicals and forces needed to build and rebuild itself. No material other than nutritious food taken into the system in proper quality and quantity can be introduced from the outside without detriment. A proper adjustment of the bony framework and the soft structures of man’s anatomical mechanism means good digestion, nutrition and circulation, health and happiness.

Osteopathy is not a theory, but a demonstrated fact. You may say there are some failures. Yes, who would not expect it? We are called to treat people who have been poisoned and diseased beyond the possibility of anything except a little temporary relief. Or perhaps the Osteopath is not able to apply the knowledge he should have gained before being granted a diploma from an osteopathic school. This reflects no more upon the science of Osteopathy than does the farmer who fails upon the science of farming. Again many are looking for miracles and are disappointed when a few treatments fail to bring wonted strength and vigor.

The early history of Osteopathy is the history of one man, its founder, Dr. A. T. Still. Its principles were first put forth by him in 1874.

Dr. Still was a regular practicing physician and during the war, an army surgeon. He was born in Virginia, his father being a minister. The family moved west and Dr. Still, during his early life, experienced all the perils and hardships of pioneer life.

Dr. Still was always of an observing, investigating turn of mind. An incident illustrative of this is told of his boyhood days. After playing hard, he was often troubled with a headache. One day he lay down under the swing tree, with the back of his neck slung in the swing rope which almost touched the ground. He fell asleep. When he awoke, he found that his headache was gone. They usually lasted him a good while and he got to thinking of it. After that when he had a headache, he went to the swing rope. Of course, all he knew about the procedure then or for years afterward was that the headache stopped. The treatment, however, was rational and its results can be explained physiologically. The pressure of the rope simply caused the tissue at the back of the skull to relax and allow the congesting blood to flow from the head.

In the early seventies, Dr. Still had three children die from spinal meningitis, in spite of the employment of every means known to medical science at that time. This experience seemed to thoroughly confirm him in the view that something was lacking in the accepted mode of treating disease. He began devoting almost his whole time to the study of the human body and investigating along lines that suggested themselves to him. He dissected animals and dug the bones from old Indian graves to get material for his study. His "bag of bones" came to be a joke throughout that part of Kansas, in which state the Still family then lived.

In his autobiography, he says of his study of the body of man, "By the use of the knife and the microscope I have traced for these many years the wonderful and perfect work therein found, carefully inspecting every fiber, gland and all parts of the brain; I have observed the construction of the parts and their uses."

Great thoughts do not come spontaneously, but the basic idea may, after years of study, come in a moment to the investigator. In 1874 Dr. Still grasped the pivotal truth of Osteopathy and that year he calls the birth year of the science. He began devoting his whole time to the development of his science and as he did so he experienced that derision and ridicule which have always been the lot of those whose discoveries have meant radical departure from the established ideas.

When, in the seventeenth century, Harvey discovered and proclaimed how the blood circulated from the heart through arteries and veins, he was designated as "crazy" by his medical brethren and ostracized from medical societies. Such was the treatment accorded Dr. Still.

His medical friends sneered at him and when he made efforts to explain to them his discovery they refused to listen to his "crazy" talk. He lost practice, his friends fell away from him. He was well to do and had accumulated considerable property in Kansas. He and his brother had donated 480 acres of land for the site of Baker University at Baldwin, Kansas. When he asked the privilege of explaining Osteopathy at the University, the doors of the structure he had helped to build were closed against him. He gradually lost his property and with his family moved to Missouri. For about ten years he traveled over the state visiting patients in various places. At times he actually wanted for life’s necessities. He finally located in Kirksville, Mo., and practiced there and throughout the surrounding country. His work was almost entirely confined to the poor and very little of it was paid for. Every now and then, rumors of some wonderful cures which he had performed pervaded the community. Among those whom he had cured, he had loyal friends, but in the main the community referred to him as "that old quack, Still" and they attributed what success he had to faith cure, mesmerism, etc. "Doctor," a lady said to him one morning, "Now, be honest with me; isn’t your success due to hypnotism?" Well, madam, it may be," replied the doctor, "I’ve set three hips already this morning."

In spite of the aspersion and ridicule heaped upon him and the difficulty of making both ends meet, he was always cheerful and optimistic and eternally confident of the world’s ultimate recognition of Osteopathy. There was always a oneness of purpose in his work. This, combined with a heart filled with charity, seemed entirely to exclude all thoughts of money matters or personal aggrandizement.

I remember an incident in my own acquaintance with him which was illustrative of this and which occurred a few years after he had started his school. I was sitting with him on his back porch and, with an open anatomy in his lap and a skeleton at his side, he was explaining to me some point of the bodily structure. A little crippled girl on crutches came around the corner of the house. She was a charity patient. "Oh, yes, I want to look after this little girl. Now you see"—and he then entered into an explanation of her condition and how it could be corrected. While he was talking, his wife came to the door and said, "Pa, Senator----‘s wife is waiting for you in the parlor." "All right, in a minute," said the Doctor, and, with one hand on the little girl’s back, he went on explaining. After a while, concluding with, "Now we’ll go over to the school," he started for the school, having to be reminded again of the lady who was waiting for him in the house. He had become so interested in the little crippled charity patient that he had forgotten all about the United States Senator’s wife whose husband was one of the most influential men in the country.

Hard work, persistence and self-sacrifice finally won. Occasionally some person of prominence became interested. His theory was so rational that these brought others. In spite of the fact that his patients were almost entirely from those claimed as hopelessly incurable by the old method of healing, some of his cures were marvelous. People began to be attracted from distances and the "Old Doctor" with his two oldest sons, Charlie and Harry, soon had as much practice as they could attend to.

In 1892, he established a school. Many of his friends tried to deter him, some thinking his ability was a gift and could not be imparted to others. Others said that he was a fool; that after all these years of struggle, he ought to hold on to his secret himself and become wealthy. But money was the last thing about which Dr. Still thought. After the establishment of the school, although opposition by no means ceased, recognition came more rapidly.

Unlike the vast;majority of the great who have made revolutionary discoveries of benefit to mankind, he lived to see the fruit of his labors—to see his science generally recognized. He died December 12, 1917, and would have been ninety years of age at his next birthday. Admired as a scientist, he was loved as a man. In the little city of Kirksville, where he lived, the citizens referred affectionately to him as the "Old Doctor," and many there are who will keep him in lifelong, loving memory. His staff laid down, his labors ended, it can be said of him as it was said of another: "Were everyone to whom he did some loving service to bring a blossom to his grave, he would sleep beneath a wilderness of flowers."

A brief outline of the present status of Osteopathy will serve to show the remarkable progress made by this system of healing since the first school was established in 1892,--a progress unequaled in a like period of time by any system which the history of the healing art records. The first class, enrolled in the school which Dr. Still established in 1892, numbered eighteen. The classes were conducted in a two-room frame cottage which today looks across the street toward a four-story building, which houses complete laboratories and facilities for instructing the seven hundred osteopathic students of The American School of Osteopathy. By the side of this building is a large hospital, one of the best equipped and most efficiently managed of any in the country.

Since the establishment of this school, other well equipped osteopathic schools have been established and modern osteopathic hospitals are run in connection with them. Besides the American School of Osteopathy at Kirksville, Missouri, there are now: The Massachusetts College of Osteopathy at Boston, Mass.; Philadelphia, Pa.; Des Moines-Still College of Osteopathy, Des Moines, Ia.; The Kansas City College of Osteopathy and Surgery and the Central College of Osteopathy, Kansas City, Mo.; Chicago College of Osteopathy, Chicago, Ill.; and the College of Osteopathic Physicians and Surgeons at Los Angeles, Cal. In addition to these schools, the profession has established the A. T. Still Osteopathic Research Institute, at Chicago, Ill. Already an endowment fund of $100,000.00 has been subscribed for its support. That it may be of the utmost efficiency in developing the humanity-benefiting truths promulgated by the founder of Osteopathy, it is the intention of the osteopathic physicians and their friends to raise $,1,000,000.00 for its endowment.

There are today seven thousand osteopathic physicians practicing their profession in the United States and Canada, and the profession has representatives in all of the leading foreign countries. Its practitioners have been accorded legal recognition in all of the states and in a number of the Canadian provinces. In many instances they have been grated independent State Examining Boards.

The national organization of the profession, The American Osteopathic Association, enrolls over fifty per cent of all graduate Osteopaths. An examination will show that this percentage of the active membership in a profession’s national organization is paralleled by no other profession in the world. The profession’s increase and progress simply indicates the public acceptance of the osteopathic idea.

My first awakening to the principles which today have culminated in the science called "Osteopathy" came when I was about ten years old. I was a boy on my father’s farm in Macon County, Missouri. I was subject to sick headaches, and while suffering from one of these attacks one day I was instinctively led to make a swing of my father’s plowline between two trees. My head hurt too much to make swinging comfortable. I let the line down to within eight or ten inches of the ground, threw the end of a blanket on it, and lay down on the ground, using the line for a swinging pillow. To my surprise I soon began to feel easier, and went to sleep. In a little while I got up with headache and fever gone. This discovery interested me, and after that, whenever I felt my headache spells coming on, I would "swing my neck," as I called it.

The next incident which gave me cause for thought occurred when I contracted dysentery, or flux, with copious discharges mixed with blood. There were chilly sensations, high fever, backache and cold abdomen. It seemed to me my back would break, the misery was so great. A log was lying in my father’s yard. In the effort to get comfort I threw myself across it on the small of my back and made a few twisting motions, which probably restored the misplaced bones to their normal position, for soon the pain began to leave, my abdomen began to get warm, the chilly sensation disappeared, and that was the last of the flux.

MILL MACHINERY INTERESTED ME

My father, as a pioneer, was a farmer, a mill owner, a minister and a doctor. I studied and practiced medicine with him.

Pioneer life on a Western farm in those days was such that all the inventive powers one might possess were given ample chance to show forth. There was very little to buy and less money to buy it with. My father had a grist and sawmill run by water, in the working of which I became very much interested. Later, I bought an interest in a steam sawmill, and took a course of instruction in milling machinery for practical purposes.

As I studied this mill machinery I got my first clear idea of the machinery of the human body. My mind invariably associated and compared the machinery of the mill with the machinery of the human being: with the drivewheels, pinions, cups, arms and shafts of the human, with their forces and supplies, framework, attachment by ligament and muscle, the nerve and blood supply. "How" and "where" the motor nerves receive their power and motion, how the sensory and nutrient nerves act in their functions, their source of supply, their work done in health, in the parts obstructed, parts and principles through which they passed to perform their duties of life—all this study in human mechanics awoke with new vigor within me. I believed that something abnormal could be found which, by tolerating a temporary or permanent suspension of the blood in arteries or veins, would produce the effect which was called disease.

With this thought in mind came such questions as: What is disease? What is fever? Is fever an effect? I took disease to be an effect, experimenting and proving the position, being sustained each time by Nature’s response in the affirmative.

Early in the sixties I took a course of instruction in the Kansas City School of Physicians and Surgeons, studying such branches as were taught in the medical schools of that day. I took up the regular practice of an allopathic physician. I was called a good doctor.

"THE PROPER STUDY OF MANKIND IS MAN"

During all this time I had devoted a large part of my time to the study of anatomy, which attracted me strongly. I read every book on the subject I could get hold of, but my chief source of study was the book of Nature. I found myself more and more believing that "the proper study of mankind is man," and the best method to pursue it is to dissect and study the body itself. The skinning of wild animals in my youth brought me into contact with muscles, nerves and veins.

The skeletons of the Indians were my next study in bones, and I went on making numberless experiments with bones until I became very familiar with the entire bony structure of the human body. Finally, I tried an experiment of my own: I made a picture or chart of the bones of the whole body, then stood blindfolded, or with my back to a table. A bone would be handed to me by an assistant. I would take it in my hands and by the "feel" of it would name it and direct where it should be placed on the chart (right or left). I carried this to the extent of even the smallest bones of the hands and feet and those of the spine, until the chart was filled in completely. This I used to do over and over again. For not less than twelve months I studied bones alone, before t aking up Descriptive Anatomy, because I wanted to know what a bone is and its use. I became as familiar with every bone as I was with the words "father" and "mother." Of course all this meant untiring work, and I have hardly expected my students to follow me over the entire length of this portion of my road. Nevertheless, I believe as strongly today as ever that the closer they follow this road, the better for their patients. They must study and know the exact construction of the human body, the exact location of every bone, nerve, fiber, muscle and organ; the origin, the course and flow of all the fluids of the body, the relation of each to the other and the function it is to perform in perpetuating life and health. In addition, they must have ability to enable them to detect the exact location of any and all obstructions to the regular movements of this grand machinery of life, and supplement this ability with skill to remove all such obstructions.

From this study in bones I went on to the study of muscles, ligaments, tissues, arteries, veins, lymphatics and nerves.

I began now to feel that I was irresistibly headed for some road: what road I myself knew not. Of one thing I was certain: I was getting farther away from the use of medicines in the treatment of ills and ails. I was a physician of the old school in name but not in fact.

I carried on my theories: I practiced them wherever I could find people who would place confidence in me, until the Civil War came on. Then I enlisted and went "to the front."

On resuming my duties as a private citizen after the war, I took up again the study and research of my all-absorbing topic: how to cure disease without medicine, and on June 22, 1874, there came into my mind the first clear conception of the practical workings of what is now known as the Science of Osteopathy. This day I celebrate as its birthday.

ONE OF THE FIRST CASES I TREATED

In the autumn of 1974 I was given a chance to try my ideas on a case of flux. I was walking with a friend on the streets of Macon, Missouri, in which town I was visiting, when I noticed in advance of us a woman with three children. I called my friend’s attention to fresh blood that had dripped along the street for perhaps fifty yards. We caught up with the group and discovered that the woman’s little boy, about four years old, was sick. He had only a calico dress on, and, to my wonder and surprise, his legs and feet were covered with blood. A glance was enough to show that the mother was poor. We immediately offered our services to help the boy home. I picked him up and placed my hand on the small of his back. I found it hot, while the abdomen was cold. The neck and the back of the head were also very warm and the face and nose very cold. This set me to reasoning, for up to that time the most I knew of flux was that it was fatal in a great many cases. I had never before asked myself the question: What is flux? I began to reason about the spinal cord which gives off its motor nerves to the front of the body, its sensory to the back; but that gave no clew to flux. Beginning at the base of the child’s brain, I found rigid and loose places in the muscles and ligaments of the whole spine, while the lumbar portion was very much congested and rigid. The thought came to me, like a flash, that there might be a strain or some partial dislocation of the bones of the spine or ribs, and that by pressure I could adjust the bones and set free the nerve and blood supply to the bowels. On this basis of reasoning I treated the child’s spine, and told the mother to report the next day. She came the next morning with the news that her child was well.

There were many cases of flux in the town at that time and shortly after, and the mother, telling of my cure of the child, brought a number of cases to me. I cured them all by my own method and without drugs. This began to stir up comment, and I soon found myself the object of curiosity and criticism.

Another case which I was asked to see brought upon me still further criticism. A young woman was suffering with nervous prostration. All hope had been given up by the doctors, and the family was so told. After a number of medical councils her father came to me and said: "The doctors say my daughter cannot live. Will you step in and look at her?" I found the young woman in bed, and from the twisted manner in which her head lay I suspected a partial dislocation of the neck. On examination I found this to be true—one of the upper bones of her neck was slipped to one side, shutting off, by pressure, the vertebral artery on its way to supply the brain. In four hours after I had carefully adjusted the bones of her neck she was up and out of bed.

WHY I STARTED A SCHOOL OF OSTEOEPATHY

I went through those interesting yet trying days deaf to criticism and comment. I worked alone, studying, investigating, experimenting.

Gradually people began coming to me in increasing numbers, and soon I found that my practice was beginning to grow beyond the limits of my strength. Several persons, seeing my increasing practice, now began to urge me to teach them a knowledge of the practical workings of my discovery. In the early nineties I concluded to teach others the principles that underlay my drugless work. I realized that I must have help or break down. I had four sons and one daughter, able-bodied young people, and the thought came to me to educate them in this science in order that they could assist me in my work.

I employed the best talent that I could find to teach them anatomy, physiology and chemistry, teaching them, myself, the principles and practice of my own science. After my school had been in running order a short time others became interested and asked permission to join, and the class increased in numbers. At the end of the first year I had some students who were able to help me in a way, and in the course of two years I really had assistance. This was the origin of what is known today as the "American School of Osteopathy."

With the origination of the school came, of course, the necessity of a name to designate the science, and I chose "Osteopathy." I reasoned that the bone, "osteon," was the starting point from which I was to ascertain the cause of pathological conditions, and I combined the "osteo" with "pathy."

So "Osteopathy," sketched briefly, was launched upon the world.

NOW WHAT IS OSTEOPATHY?

Many people naturally ask: "What is Osteopathy?"

Osteopathy is simply this: The law of human life is absolute, and I believe that God has placed the remedy for every disease within the material house in which the spirit of life dwells. I believe that the Maker of man has deposited in some part or throughout the whole system of the human body drugs in abundance to cure all infirmities: that all the remedies necessary to health are compounded within the human body. They can be administered by adjusting the body in such manner that the remedies may naturally associate themselves together And I have never failed to find all these remedies. At times some seemed to be out of reach, but by a close study I always found them. So I hold that man should study and use only the drugs that are found in his own drug store—that is, in his own body.

Osteopathy is, then, a science built upon this principle: that man is a machine, needing, when diseased, an expert mechanical engineer to adjust its machinery. It stands for the labor, both mental and physical, of the engineer, or Osteopath, who comes to correct the abnormal conditions of the human body and restore them to the normal. Of course, "normal" does not simply mean a readjustment of bones to a normal position in order that muscles and ligaments may with freedom play in their allotted places. Beyond all this lies the still greater question to be solved: How and when to apply the touch which sets free the chemicals of life as Nature designs?

Osteopathy to me has but one meaning, and that is, that the plan and specification by which man is constructed and designed shows absolute perfection in all its parts and principles. When a competent anatomist (as the successful Osteopath must be), in treating the human body, follows this plan and specification, the result will be a restoration of physiological functioning from disease to health.

An Osteopath is only a human engineer who should understand all the laws governing the human engine and thereby master disease.

The science of Osteopathy primarily depends for its success upon a thorough and comprehensive study of the anatomy and physiology of the human body. Osteopathy has for its object the maintenance of the complete circuit of the motor, sensory and sympathetic nerves, to and from all the organs and tissues and the restoration of that harmonious action which must ensue when all parts are unirritated by any cause, thus permitting a perfect freedom of all fluids, forces and substances pertaining to life.

In the application of this knowledge to the healing art is where the School of Osteopathy differs from its predecessors. Osteopathy retains the knowledge gained in the medical world, but believes that the administration of drugs in a remedial sense is a mistake and that, by a thorough understanding of the mechanism of the human system, on an anatomical, physiological and hygienic basis, disease can be prevented or controlled in an exact and definite manner by the application of principles peculiar to osteopathic practice.

More and more it is being realized that the use of drugs is not to be depended upon; and the intelligent physician, as well as layman, is not satisfied with the results. It is even questioned whether their use has not been more harmful than the sum of all the diseases of mankind.

Osteopathy, on the other hand, depends for its remedial effects upon the integrity of nature; consequently the Osteopath believes that the giving of drugs for the cure of human ills is unreliable and unscientific.

HUMAN SYSTEM COMPLETE IN ITSELF

The human system is a perfect organism, a universe within itself, and being complete has the recuperative power of Nature within it. If such were not the case, the human body would be incomplete, man would be obliged to seek extraneous aid in the alleviation of disease, and in such instance the use of medical agencies would probably be more of a success.

The first step in osteopathic attainment is an exhaustive knowledge of anatomical structures and the physiological functions of the human body. Then is observed the fact that man is a complete being, capable of performing his own mental and physical acts when in health; that disease is simply evidence of disorder, and to restore health necessitates a correction of disordered parts.

The human organism contains the attributes of a physical mechanism. Vital functions are conditioned and amenable to the structural laws of physics. This fact determines the value of the science of Osteopathy—its practicalness. Herein is contained the essence of the art of Osteopathy.

In the restoration of health the Osteopath works entirely in harmony with nature, correcting disorders of mind and body upon a physical basis through the application of his knowledge of the laws and principles of the human body, thereby looking upon disease as some disorder of the normal function of the body, and not as an entity to be attacked by some foreign force which would only alleviate, antagonize or overshadow the real trouble.

EXAMINATION OF THE PATIENT

The patient is examined from a physical viewpoint. Pathological conditions and symptoms are used as clews to find the cause of the disease. Back of these signs and symptoms of the disease must be traced the origin of the nerve supply and the course of the blood channels from the parts diseased to the exact region, or primary lesion, causing the abnormal condition.

The cause of the disease may be a dislocated or sub-dislocated bone, ligament, cartilage, or muscle, producing an inhibition or irritation of a nerve fiber or causing obstruction to an artery, vein, lymphatic or some fluid of the body, thereby resulting in disorder to that part of the body to which the affected nerve or vessel is connected or distributed. When the point of exact cause of the disease is located, aid is given crippled nature in reestablishing the normal activities of its forces.

OSTEOPATHIC TREATMENT

The mode of treatment is a scientific manipulation, applying the mechanical principle which is indicated in each separate case. Osteopathic treatment is not simply applicable to a particular line of diseases, but controls with precision and success all curable diseases of the entire category. Its newly discovered principles, peculiar to osteopathic practice, are of an unerring and comprehensive nature.

Osteopathy’s laws and principles, being in harmony with, and, in fact, part of the infinite natural forces of life, show its predominance over all previous schools of medicine.

The Osteopath does not depend upon medicine to act upon the structure or function of the disordered tissue, for the diseased tissue is simply an effect, but he relies upon the natural forces within the human body. He first corrects the structural deviations of any region that may be affected and thus restores physiological harmony to the diseased parts, and this being done, health must ensue.
 

In an open hearing before a committee of the State legislature of New Jersey, a question was asked by one of the members of the committee that went unanswered.

"What," said he, "is the point of departure between Osteopathy and medicine?"

If we are right in believing that all who think at all about Osteopathy ask themselves consciously or unconsciously the same question, then the answer will be pertinent here.

The most conspicuous point of departure is that the doctor of medicine gives medicine; the osteopathic physician does not, but instead corrects structural disorders, which the medical doctor does not, and leaves the rest to Nature. Many things they have in common, that is, they both correct bad habits, advise diet, use surgery occasionally, etc.

In his mind the average man asks why this is a point of departure? Are the two systems not compatible?

They are incompatible. And they are incompatible practically, psychologically, historically, educationally, scientifically, and philosophically.

PRACTICAL POINT OF DEPARTURE

The osteopathic physician corrects disorders because he finds them. No other reason need be given. And he leaves the rest to Nature because he finds that that is all that is necessary. A purely practical thing is the practice of Osteopathy. The practice of medicine, on the other hand, uses medicines because it "believes" in them and because the authority of its school teaches them; that is to say, because such is the traditional practice of that profession. It is not because medicines have been found efficient. What the medical world really has found out about medicines is—that it has to keep on discarding them, and hunting for new ones.

PSYCHOLOGICAL

Is the use of the word "belief" here justifiable? I think it is, and incidentally it brings us to the psychological point of departure. "Belief" in drugs is buried centuries deep in the mind of the whole people When some man becomes a doctor of medicine, he carries this belief with him. It takes years of practical experience to shake it. As fast as the belief is destroyed at the top it is renewed again at the bottom.

Also one believes in what one does. The belief in drugs is a natural consequence, as well as the cause, of giving them.

No fault is to be found with the medical profession for this. The medical profession is merely that part of the great public which devotes itself to the care and the cure of disease along traditional lines. The fault, if it is a fault at all, is to be attributed to human nature—mystery-loving, miracle-loving, conservative—living nine-tenths in the shadows it has itself made.

HISTORICAL

The historical point of departure dates from the very beginning of Osteopathy. It was rejected by the medical profession. Dr. Still proclaimed his new discoveries to his brother practitioners of medicine of that time and place, and has continued to present them ever since. They were and are rejected as being impossible and absurd; which means that they are incompatible with the training of the medical mind and with the practice of the medical school.

Compelled thus to grow up outside the medical school, the new practice nevertheless continued to develop until it became both a separate profession and a separate science. It cured and continued to cure those who came to it, many of whom thereupon became practitioners—practitioners on whom medicine and surgery had failed—and these helped to emphasize the difference between medicine and Osteopathy.

The strongest point in the historical departure was this, that Osteopathy had an opportunity at first with only those on whom medicines had failed; whereas medicine handled all cases as they came, of whom at least eighty-five per cent recover anyway, with or without medicine; for which nevertheless medicine gets credit. Thus only in the case of Osteopathy was there a fair test of value. This test was immensely favorable to the new system.

Its success, however, did not bring about the glad acclaim of the medical practitioners. Instead it hardened their hearts. Nor is this to be charged against them as a bad mark. It is not medical, it is human.

We are not under the necessity of apologizing for human nature; but it marks a point of departure between Osteopathy and medicine.

EDUCATIONAL

In its growth, therefore, Osteopathy followed the lines of least resistance and grew up a separate system; though it is a matter of fact that another medical practitioner, from Edinburgh, a fellow of the Royal Society of Edinburgh, was farseeing enough to put the pressure of his undoubtedly great genius behind the anti-medical tendencies, to establish the independence of Osteopathy as firmly as he could. This man was William Smith, M. D., C. L., F. R. S. E., D. O.—of which titles he valued the last the most.

Far from being a disaster, this absolute division proved to be the finest thing possible for the new science. If, by new methods, the old ones could be shown unnecessary, then was the world so much the gainer; for the old ones were at all times dangerous, and, with the least incompetence, deadlier than the disease.

Thus the educational departures of the new system became absolute. This enabled the new system to carry its measures to the highest possible efficiency.

SCIENTIFIC

As to the scientific point of departure, a scientific criticism of Osteopathy by the medical profession was never made. This was at first galling to many members of the osteopathic profession, but it need not have been. The last possible thing that a crowd or any mass of men, or even a profession, is capable of, is scientific thinking. Science is an individual matter. With the mass of men, taken as a whole, it is an art. K And one art is typically jealous of the other arts. This the public does not see, of course, and it seems that the legal mind does not see it any more easily; for it has tried persistently to compel the two to mix.

But the science of Osteopathy also has its exclusiveness; and in spite of the excellence of many scientific minds in the medical profession, it is impossible for the science of Osteopathy to lessen the rigidity of its scientific exclusiveness. First the medical profession practically rejected the science of Osteopathy. Then finding itself isolated and defined, the osteopathic profession found also that it had in hand a science that would not mix with medicine. This is in no sense a personal or a professional matter—it is not the act of a man or men—it is a question of science. The osteopathic profession found its science positive. It found that it could harmonize its positive findings with the positive pathology of general science, and with its own therapeutic measures. It found that it could not harmonize the definite and positive facts and principles of its science with the guesswork of the medical practice. Osteopathy was positive and exceedingly helpful. Where its helpfulness failed and its logic would not reach, there it was admissible to have recourse to experiment again, as the world had always done – had always had to do. But in so far as there was a definite and positive thing, experimental practice was simply shoved farther away from the problem of disease.

So long as the medical profession held the medical system to be fundamental, to be curative and not merely experimental, to be positive and not merely palliative or an emergency system, so long was no compromise possible. This is, of course, a matter between the professions, not between the sciences. Science is impersonal and cannot take sides. It is a matter for proof, not for warfare; science cannot disagree with science. Scientists may dispute with scientists, however, and will to the end of time.

In practice, as all of the world knows, from the beginning up to the present time, the majority of the medical profession has acted upon this principle; it has claimed exclusive rights in therapeutics and in authority. It has again and again shown an inability to develop self-criticism. This is not the fault of the men but of the system, or perhaps one might say, of human nature. The whole spirit of the miracle-search is opposed to pure science or any science. Mystery and miracle go hand in hand.

But granting this fault in the philosophy and in the practice of medicine, is there yet no basis on which any of the great mass of work done by medical men can be made available—can be found compatible with the osteopathic science? The omission of materia medica from osteopathic schools does not mean the omission of surgical and sanitary medicines nor is it to be understood as meaning necessarily a denial of any truth or value in materia medica. Science cannot take negative attitudes. It is, however, a very positive assertion of the superior value of osteopathic means and of the greater need of developing those means.

The contrast must be made between the traditional practice of medicine and the wonderfully valuable research work being done in the medical laboratories. Of this latter it is impossible to speak in terms of too high praise. The devotion and ability there has brought this age a degree of progress which must, when true perspective is obtained, stamp it as the great therapeutic age. The research that is of value, however, is that in physiology, biology, bio-chemistry and surgery, rather than in medicine. All the progress in medicine that is of value has come through surgery. Sanitation is a department of surgery, as are the wonderful agencies for the deadening of pain. In all of this Osteopathy rejoices and profits.

PHILOSOPHICAL *

[*PHILOSOPHICAL is here used in its commonly accepted meaning as pertaining to the knowledge of the causes of all phenomena both of mind and matter, rather than in its strictly technical sense.—Ed]

The philosophical point of departure is no less definite and absolute.

In medicines and other systems we have experimental methods for curing diseases. Whether it be drugs or electricity or hydrotherapy or psychotherapy or any form of therapy, they are all attempts to make a wide or universal application of a thing that proved good in some cases. They are entirely experimental methods, merely trying for further results with little reference to causes, processes and laws which are almost entirely unknown.

They prove themselves mere methods, because they adopt other experimental methods and find no incompatibility in doing so. They prove themselves experimental methods in the very criticism their exponents make of Osteopathy, being unable to see in it anything but another mere method. In contrast to these experimental methods stands the osteopathic practice, based on the actual facts discovered in the individual case, agreeing with biology and explaining pathology; moving not at all until it finds disorder and then only moving to correct this disorder and not allowing itself to be drawn into mere guesswork, preferring rather to leave all to the understanding of Nature except in so far as it can remove the causes of disease.

Osteopathy holds that since all the forms and processes in the body are the expression of laws, therefore disease also is the expression of laws, is a normal result of causes. Any attempt to cure except by removal of causes is an attempt to suspend the operation of law.

These two contrasting systems cannot live together in the same mind. Those schooled in experimental methods who have sufficiently considered the osteopathic doctrines are convinced by them, and become osteopathic physicians and cease to be "believers" in medicine or "believers" in anything else; but rise to the higher scientific plane of working with the facts and trusting in them.

Osteopathic philosophy is based absolutely upon this principle. It considers no move justifiable until that move can be based upon knowledge. It considers it rarely justifiable to interfere with or to suspend Nature’s processes, for which she has reason; or to nullify her laws, which are the conditions under which she moves. All honor to scientific experimentation, but the worst possible travesty of science, the most pessimistic, indeed the most atheistic and chaotic attitude toward Nature, is that which justifies blind experiment in an ordered physiological being. No justification can be found for experimental methods, except in the absolute lack of sufficient knowledge of cause and effect, and then only in the effort to find such cause and effect. In fact, this effort is continued only because the public demands that some effort be made to cure or to discover a cure for their diseases.

The philosophy of the medical system, if it can be said to have a philosophy, seems to have been based upon the doctrine that everything made by the Creator was made for some purpose of man. Possibly most of us would agree with this, but when the medical profession goes on to assume that He put ready to our hands all the herbs of the field and all of the chemical and other forces of nature, therefore He meant that these be used for our relief in disease, we most heartily disagree. The logical fault of such a doctrine is that it has no virtue. As well say, twice two is a pot of beans. It has been broad enough, however, to justify almost any conceivable vagary that any dreamer with the medical degree could devise.

This philosophy can hardly be called a philosophy. It is merely an inheritance. What the facts really are is as follows: In so far as it is a mystery the only way to reach it is through experiments. The public demands that some effort be made, and it loves miracles. The search for specific remedies is the search for a miracle. Mystery and miracle go hand in hand and must forever go hand in hand. This miracle idea is a lineal descendant of the Philosopher’s Stone, with which students of history are familiar, the parent of alchemy and through alchemy the parent of medicine. The survival is not a science but a psychological phenomenon; not a fault of any group of men but an expression of human nature.

In contrast with this, the philosophy of Osteopathy asserts that since the majority of mankind remains healthy under given conditions, and one or two become sick under these conditions, therefore the power exists in the organism to remain healthy, and the reason why illness arises in some cases and not in others is to be sought for in some difference in those individuals. That difference is hunted for and found; and on it is built the practice of Osteopathy. Nature does not create functions to exist only as diseases When disease does arise, it presents a question for determining what are the compelling causes. These compelling causes were found by Dr. Andrew Taylor Still to consist of actual disorders in the parts of the body. As such they were studied. Thus developed the science of Osteopathy.

The philosophy of Osteopathy is the philosophy of fact. The osteopathic profession makes a positive diagnosis of actual disorders found in the structure of the body, affecting its functional balance. It makes a positive claim of being able to remove such disorders. It shows in terms of known physiology the relation between the disorders and the result. In most cases it presents records (made by men capable of making such records), of benefit or of cure, from the removal of these causes.

The great point of departure than between Osteopathy and medicine is that between a practical fact and experimental practice.

It is a hopeful sign, however, to observe that the foundation of this false therapeutic structure is being undermined—is crumbling away. We are searching more deeply into the cause and studying less the effect (except as it points to a cause) and its remedy. It is gratifying to note, too, that this change is largely co-existent with the origin and development of Osteopathy. This science, making less prominent the effect, the symptom, and being satisfied with nothing short of the discovery of a first and primary cause, has done more to bring about a better understanding of the "human machine" in its relation to diseased (or disordered) conditions than any other one therapeutic system. Its viewpoint is from an entirely different field and we will endeavor to demonstrate that it has a more rational basis.

In order to understand better this new conception, let us for the moment forget all about Osteopathy which may, in our individual interpretation of its meaning, seem vague and indefinable, and, without being prejudiced, consider in a rational way a few well-known physiological principles.

Bodily tissues, muscles, glands, organs, etc. (without nerves to govern their actions) are inert, mere masses of matter, unresponsive and lifeless. Every movement of the body is the result of muscular contraction—an approximation of the different points to which the muscle is attached. But the muscle cannot contract itself; it has no inherent power to act, it lies there dormant until put into motion by an independent force. This force, generated in the brain, or other subsidiary center of origin, is transmitted along the nerve especially created for it to its point of action. Without this impulse, or stimulus, the muscle is helpless. This is true of all muscular contraction and is demonstrable beyond any question. A similar phenomenon is undoubtedly true of all other functions. For instance, the stomach secretes certain digestive fluids. In this process of secretion, the secreting gland acts, as does the muscle, only when influenced by the nerve impulse starting from its center of origin and terminating in the gland. In like manner, we can logically assume that every other tissue and organ exhibits similar phenomena. Even the blood and lymph circulation, on which bodily health so much depends, is similarly controlled. The heart, the greatest propelling force, is a muscular organ acting as do other muscles. The walls of the blood channels are everywhere supplied with muscles and their governing nerves control their caliber, thereby regulating the quantity of fluid passing through them. Knowing these facts by practical experiment upon most of the bodily tissues, we dare assert that all function is governed by nerve stimulus, originating in the brain—or similar subsidiary center—and transmitted through the nerve to the organ or part.

With this conception of physiological function, we reasonably assume that health exists when functional life is normal—when the organ or part is in action in response to a normal nerve stimulus and that disease is the result of the opposite condition—a friction of parts, an interrupted nerve current and other causes to which these are contributory.

But why the opposite condition, this abnormal action? Let us consider for a moment a condition that might produce this friction, or interference with the nerve current. The human machine, as are other machines, is subject to certain mechanical laws which must be obeyed. On account of its delicate structure and sensitive nature, it is even more susceptible to a violation of these laws than is the mere mechanical device. A disturbance of the relation of the parts, even though slight, produces friction somewhere, or impedes or restricts the nerve current. This done, function is impaired or ceases in the organ supplied by that nerve. The products of that organ become deficient in quantity or quality—often in both—or its power to excrete the poisonous bodily waste ceases. Disease results with severity in direct proportion to the importance of the function impaired, to the amount of destroyed tissue, or according to the amount of poisonous matter retained in the system. To restore health, function must be re-established. How shall this be done? We might cut away the diseased part; we might cauterize the area involved and cleanse it. But if we do nothing to re-establish the function, to adjust the structure interfering with that function, continued or progressive destruction must follow.

There is only one way in which tissue can be reconstructed. The work must be done by the natural tissue-building properties of the body, the normal blood and lymph and the products of digestion properly assimilated. No medicine will do this for the organ. The most expert chemist, with any possible combination of drugs cannot construct tissue—no drug or combination of drugs will build tissue. In order to heal a wound there must be brought to it, through the natural channels of the body, the tissue-building materials, food elements, the product of digestion.

Obstructions are referred to above. What are they? Why do they exist? How do they originate? What effect have they on functional life? For the purpose of this article reference to one class will suffice. The spine is composed of a number of bones, vertebrae, one upon the other, being so perforated that together they form a bony canal in which lies the spinal cord. A joint is formed at the juncture of each pair of adjacent bony segments of the spine. The spine, therefore, is a series of joints as well. Now the function of a joint is motion. This is what it is created for—movement. Sometimes this motion is impeded; sometimes it ceases altogether. Strains and injuries of various nature induce inflammatory action, forming adhesions or producing thickening of the component parts of the joints. This is one form of obstruction. The result is disease—disorder. But this obstruction in itself is not necessarily a serious condition. The stiffness of a single joint of the spine need not interfere with much bodily activity. The bending of the spine is not an absolutely essential element in life. But passing between adjacent vertebrae are two nerves, one on either side, the media through which is transmitted the energy governing other and often much more important functions. As the joint becomes restricted, ligaments around it contract and harden, excretions infiltrate the tissues and disturb or decrease the size of the passage in which the nerves lie to such an extent that all nerve energy may there be dissipated. The organ supplied by such nerve, therefore, becomes inactive—its function ceases and its individual life is impaired. Again, since the spinal cord receives its blood supply--nutrition—through these same openings, most serious damage may result from a lack of blood there and a consequently starved nervous system.

Impaired motion of the spinal joints and the accompanying hindrance to the spinal cord circulation are not the only obstructions that may exist. Strains and contractions of muscles often cause various irregularities of the joints. A single vertebra may be "slipped" to the side (of course only slightly, otherwise severing the cord or causing a pressure upon it sufficient to produce paralysis at that point), a rotation may exist, or a slip or rotation of a series of vertebrae—thereby irritating, directly or indirectly, the nerves passing from the spinal cord, by drawing tight the vertebral ligaments.

Thus far, it has been the aim of the writer to make plain one form of "lesion"—"perverted structure which by pressure or other irritation produces or maintains functional disorder." It is not the intention so to confine the subject. There are other forms of lesion, many of them; but to go into detail with each class, since the principle is generally applicable, is useless.

The osteopathic viewpoint, therefore, is based in general upon the principle that "structure (anatomical relations) determines function." Health exists when there is harmony in structure. Disease follows disordered relations; or disease is the result of (first) structural derangement which inevitably produces (second) perverted or suspended function. (The writer is aware that abuse may modify function thereby originating pathological conditions, but that phase of the subject cannot be considered in the brief space allowed for this subject.)

Osteopathic therapeutics, therefore, depends upon the mechanical principle of adjustment of structure. It contemplates that the bodily functions are maintained by the harmonious, unrestricted action of all parts. The presence of disease indicates primarily structural derangement--interference with the free action of the vital forces. To locate this derangement, together with a consideration of all its associated consequences, constitutes the substance of the Osteopath’s diagnosis. Then, his therapeutics is an adjustment, by manual operations, of that abnormal structure, adapted to the individual condition and varying according to the particular needs. When this adjustment is secured, by the removal of the obstruction and a consequent liberation of nerve energy—a restoration to normal function—nature rebuilds or restores the weakened tissue.

Nature always tends toward the normal so long as she has freedom of action. Her power to do this is inherent. There is no external force which will supply her demands in artificial doses. She needs no tonic or stimulant—no whip. All that is required is the freedom of action with which she was originally endowed by an all-wise Creator.
 

From an osteopathic point of view, a lesion is any abnormality of structure which interferes with function. Do not get the idea that these lesions are great big things, that there must be a dislocated vertebra or rib, or a spinal curvature or some great abnormality in order to constitute a lesion. There are comparatively few lesions of that kind. When there is the least particle of abnormality of position of spinal structure or when there is a change in the relation of bones, ligaments and muscles, these conditions constitute lesions. We may have a rotation of a vertebra and that is a lesion; we may have a curvature of the spine and that is a lesion; we may have a straight spine and that is a lesion; a rigid spine, hardened or tensed muscles all constitute lesions. They are all lesions because they are abnormal structural conditions and interfere with the origin and transmission of nerve force.

We must recognize that the nervous structure is the master structure: nerve tissue the master tissue. When there is anything wrong with the nerve impulses, some disturbance of function is going to occur. You all know that the nervous system is very much like an electric-light plant. The impulses originating in the central portion of the nervous system, the brain and spinal cord, are transmitted all over the body. The brain is the dynamo, the nerve fibers are the wires. In the electric-plant, if the dynamo should get out of fix, we could have no light; so if something is wrong with the nutrition to the brain or spinal cord, the impulses will not be normal. If the wires are broken or short circuited, the light goes out; so with the nervous system, if the nerves are impinged upon or irritated, of course there will be interference with function—the impulses will not be normal.

In order to have good digestion, good elimination, etc., we must have the proper distribution of nerve force and no interference with the nerves after they leave the central nervous system. Any of the lesions spoken of might interfere with the nutrition to the central system where the nerve cells are allocated. The spinal cord and brain must be nourished with good blood. The blood carries nutrition from the gastro-intestinal tract to the central nervous system. If there is any interference to the blood supply on account of spinal lesions, the nervous impulses will be weak and the individual will not have good health. Wherever there is a lesion, there is obstruction; interference with the intervertebral foramina, interference with the vaso-motor nerves which control circulation and interference with the central nervous system.

We find the principal cause for most of our chronic ailments to be either reduction of vitality at the nerve center due to interference with nutrition or some mechanical interference with the nerves themselves.

All lesions found along the spine do not result from injury or trauma. Some do, of course, but most of them come on slowly; not in a day or a week and not because we step into a hole or fall. Most of them come on slowly and may be two, three, four, five or even twenty years in developing. Then how did they come about? Strain is one cause, overwork, exposure and many times infectious diseases, where the individual is extremely ill for a period of time; all these are causative factors which will produce a warping and twisting of the spinal column and bring about mal adjustment. Chronic diseases come on as a result of these slowly developing lesions.

In practically all cases where there is lesion, there is limitation of motion. The question is sometimes asked, "How are lesions maintained?" I have made the statement that we do not have complete dislocation in order to have lesion, but limitation of motion which interferes with nutrition to the nervous system. As the lesion develops, the abnormal position produces a local irritation or inflammation. New tissue forms about the site of the lesion, causing adhesions at that point, and as these adhesions thicken, the ligaments and muscles lose their elasticity, stiffen and harden, maintaining the lesion.

In chronic diseases, by breaking up the adhesions, where there is fibrous tissue formed; by the establishment of motion, where motion is indicated, and by the correction of structure, we remove the interference to the nutrition to the nervous system so that impulses may be properly originated and properly transmitted and the organs perform their normal functions.

The object of osteopathic manipulations being largely to adjust the bony structures of the body to their proper relative position for the purpose of removing interference to the physiological action of organs and to promote the cure of disease, the manner of procedure is of interest.

The first consideration is the establishment of a correct diagnosis of the pathological condition, to which end the usual methods of physical and laboratory diagnosis may be employed. Having located the seat of the pathological condition and the extent of organic changes in the tissues of the body as far as possible, the next step is the analysis of the cause which might have led to the perverted functioning or to the organic change, determining whether motion, sensation or nutrition be interfered with. The avenues of travel for the impulses controlling each of these functions that may be found disturbed are then searched for possible cause of interruptions to the normal movement of such impulses, or for reflexes that might divert or augment them. The nerves and blood vessels being seldom subject to abnormal pressure while passing through the softer tissues of the body, it is but reasonable to suppose that the most likely point of mechanical interference is at some point where they come into relation with the denser structures of the body. It is then the duty of the Osteopath to examine closely the relation of the vertebrae, ribs, innominates, etc., to find the exact point or points of interference to the forces that present evidence of disordered physiological action in the case at hand. In this the osteopathic method is peculiar, individual and distinct from all other methods of examination. The usual physical examination for the determination of the organ functioning improperly, guides the Osteopath to certain definite points along the spine where the nerves controlling that function center and, on the other hand, should the Osteopath make the spinal examination first his findings of structural deviations there would, according to their location, indicate to him more or less accurately the organs whose functions are disturbed.

So much for the diagnosis, and having established the same both pathologically and osteopathically, the Osteopath proceeds to treat the case along osteopathic lines in accordance with the findings, or he may refer the case to the best means available for the care of the conditions, whether it be surgical, institutional or otherwise, as may be indicated.

Proceeding with the osteopathic treatment, for that concerns us most at this point, the patient, dressed in clothing that will permit of freedom of motion to the spine and extremities, occupies a sitting or reclining posture that will afford the greatest ease of operation for the physician and will allow muscular relaxation of the parts to be adjusted. The Osteopath uses his hands to make the adjustments. From his knowledge of the structures of the body and the relation of the parts under operation, he chooses a point to be used for a fulcrum, while the leverage necessary to place the structures in their proper relative position is usually obtained by the use as a lever of one or more of the bones adjacent to the point of lesion, or structural abnormality, which is the object of his attention. Not so much force as skill is required to bring about the adjustment desired. Each particular lesion requires a certain definite fulcrum or fulcrums and a certain definite lever or leverages used singly or successively to move the structures to their normal position.

The technique of each osteopathic adjustment is exceedingly complex and difficult of proper execution, requiring, as it does, a highly sensitive touch, complete knowledge of the structures and their physiological relations at the seat of the operation, judgment as to the placing of the fulcrum and the choice of levers, acquaintance with the laws of mechanics governing the use of levers, consideration as to the amount of energy necessary to operate the levers used to bring about adjustment without producing pain or discomfort for the patient. All these and more the osteopathic physician must bring to bear with skill upon each problem of adjustment that he attempts to solve. Every movement that the physician makes during each manipulative procedure is done with a certain definite end in view according to the needs presented by the situation. Nothing is done by rote, the individual case requires definite and specific treatment, whether it be to secure the adjustment of one vertebra or a dozen that may be out of normal position.

The question is often asked how many treatments, corrections or attempts to correct a given lesion, may be necessary before it will remain in normal position, and it is a very difficult question to answer, there being so many factors concerned in the cause and maintenance of these structural perversions. Practically speaking, each case is a law unto itself. A single correction, which being afterwards maintained, has given Osteopathy many a glorious victory over disease. On the other hand, in old curvatures for instance, where there is change in form as well as in position of the vertebrae, no number of attempts at correction could be crowned with perfect success. Often the ligaments about the lesion have thickened as the result of inflammatory changes, just as they do about any sprained joint, in which case the Osteopath is confronted with a problem that will take time and repeated efforts at correction to successfully solve. Other things being equal, the relief of functional disturbance or the benefit given organic disease is usually in direct proportion to the degree of success obtained in the correction of the lesions, provided, of course, that the organic changes have not progressed beyond all possibility of help from natural sources.

The length of time necessary for a treatment varies according to the needs of the case at hand, and the dispatch with which the physician is able to recognize such need and apply suitable remedial measures. In a case presenting a single twisted rib that is manifestly the sole source of functional disorder, it would be folly to spend time in going through motions about the other ribs. The single rib might be adjusted in a minute or two. On the other hand, it would be equally as unwise to confine the attentions to one rib when several ribs or vertebrae are concerned in the lesion. Here again each case is a law unto itself and the judgment of the practitioner must interpret the law.

There are those who are burdened with the idea that osteopathic treatment is strenuous, rough and painful, and from certain quarters this idea is encouraged by statements to the effect that only the strong can withstand the treatment. However, the truth is that the treatments are gauged to meet the needs of the patient whether it be a babe, a feeble old person or an athlete. Here is where the Osteopath’s judgment is called into play to meet the condition of the patient, as is a medical physician’s judgment in the choice of dosage. Even the most skillful operator cannot promise to work always without discomfort or pain to his patient, but if he is conscientious, he will accomplish the end desired with the least possible discomfort to his patient. Points that are extremely sensitive to the touch because of the conditions incident to the lesion or areas of inflammation, are treated indirectly so that the pain of treatment is minimized, but most osteopathic procedures are not necessarily associated with pain.

With regard to the frequency of treatment for the individual case, this too is a law unto itself. In acute conditions several treatments within twenty-four hours may be indicated. Others may require treatment daily, and from that to once weekly or only occasionally, according as the need may be apparent.

Another question frequently asked is concerning the corrections and the permanency of the results of osteopathic work. Here nature assists the physician with a tendency to maintain normal structural and functional conditions. While the same circumstances that produced the lesions in the first place may operate to produce the same again, yet with the tendency being toward the normal and the patient instructed to avoid possible repetition in the action of the forces that produced the lesion, the results are largely of a permanent nature, the improvement being both specific and constitutional.

Osteopathy absolutely differs from massage. The definition of "Massage" is masso, to knead: shampooing of the body by special manipulations, such as kneading, tapping, stroking, etc. The masseur rubs and kneads the muscles to increase the circulation. The Osteopath never rubs. He takes off any pressure on blood-vessels or nerves by the adjustment of any displacement, whether it be of a bone, cartilage, ligament, tendon, muscle, or even of the fascia which enfolds all structures; also by relaxing any contracture of muscle or ligament due to displacements, to drafts causing colds, to overwork or nerve exhaustion. The Osteopath knows the various nerve-centers and how to treat them, in order that the vaso-motor nerves can act upon the blood-vessels, bringing about in a physiological manner a normal heart-action and freeing up the channels to and from the heart. The Osteopath deals always with causes, has no "rules of action," as such, but applies reason to each case according to the conditions presented, treating no two cases quite alike. He knows from past experience that the effect seen is produced by a cause with which he must deal in order to give relief.

The Osteopath is a physician. The masseur does not take the responsibility of the full charge of a diseased condition, but works under the direction of a physician, and has to do with effects, applying by rote to the body so much rubbing, so much stroking, so much tapping, so much kneading, etc., there being definite rules laid down applicable to general cases.

Osteopathy is a science and an art also. It includes a knowledge of anatomy, biology, physiology, chemistry and pathology. Its therapeutics are independent and original, and as extensive as the entire medical and surgical fields.
 

AN ILLUSTRATION
By Asa Willard, D.O.

A barber and a surgeon both work on the body with sharp instruments, yet their work is different. A Homeopath is not an Allopath because they both use drugs. There is a difference between the stone mason and the sculptor. The masseur uses his hands in his work; so does the Osteopath, and there the comparison ends.

Massage is a system of movements, certain slappings, rubbings and squeezings, done by rote and learned in a few months. An Osteopath is a trained physician seeking out the cause and removing it. The masseur finds a limb congested or badly nourished and goes about rubbing and squeezing to stir up the stagnant circulation. You could do this in the case of the arm which has gone to sleep because it has been hanging over the back of the chair, or the leg because it has been crossed, but only temporary relief would be afforded if the limb is not moved in such a manner that the pressure upon the nerves and blood vessels is removed. The Osteopath would seek out the point where obstruction exists to these nerve and blood currents, remove that obstruction and open the channel. This done, he reasons that the heart will propel the blood, and that the nervous system will attend to its distribution in a normal manner. He stretches muscles when necessary; he relaxes ligaments and adjusts to their normal relations bones, cartilages and other dense structures, but he does not stroke and rub the surface.

Dr. Still has been described as, "The original citizen of Missouri to demand visual demonstration." He applied the "Show me" test to the theories of medicine and to his own theories of treatment as well. He was always searching for demonstrable evidence of the scientific value of any theory. That which stood the test was retained as truth; that which failed in the test was rejected.

From the first announcement of the osteopathic theory, there have been those who have pooh-poohed the idea of structural perversion being responsible for disease. Their conception of structural derangements was limited to gross dislocations of the joints. They could neither recognize nor conceive that it was possible for minor displacements of the structures of the body to occur. That such should be a controlling factor in disease was to them absurd.

Such evidences as have been gathered by trained observers point unerringly to the support of the principles of Osteopathy as advanced by Dr. Andrew Taylor Still. These scientific observations include those made in the clinics, in the anatomical and experimental laboratories of the several osteopathic colleges, and the observations and experiments at the A. T. Still Research Institute in Chicago, besides the work of many individuals in private practice.

The evidence gathered in the clinics shows that a group of symptoms in an individual which is recognized as a disease is with great uniformity secondary to certain structural deviations, usually of the ribs or vertebrae, which are anatomically associated with the parts in which the symptom or symptoms are manifest.

Examination and graphic tracings of spinal structural relationships reveal that certain definite alterations of the normal relationships are associated with the disorders in the organs anatomically associated with that portion of the spine where such alterations occur. The readjustment of the structural relationships is followed by relief of the functional disturbances—the symptoms.

In the hundreds of dissections of bodies that have been made in the anatomical laboratories at osteopathic colleges, observations have been made and recorded of existing altered relationships in the framework of the body which, it could be demonstrated, interfered with the blood or nerve supply of organs that were found to be diseased. The same points have been observed and recorded at autopsies.

The X-ray has repeatedly been able to present on the photographic plate a record of the faulty position of some of the ribs and vertebrae constituting an osteopathic lesion, when the same condition escaped the tactile sense of those not accustomed to spinal palpation. In numerous instances the X-ray has shown such parts in correct relationship after adjustment by osteopathic treatment. The X-ray, then, offers scientific proof of Osteopathy.

Besides the clinical evidences, the spinal tracings, the dissections and the X-ray findings, various animal experiments have been conducted by several competent observers over a period of about ten years. These experiments have all tended to prove the osteopathic theory that spinal strains, curvatures and slight displacements affect the nerves and blood vessels of the organs to which the nerves are distributed.

The spinal lesions experimentally produced in the animals were not accomplished by violence. With the animal relaxed under anesthesia, slight displacements were made by pressure and rotation without greater force than a child might receive in play and immediately forget. After being under observation for varying periods of time, up to several months, the animals were killed and careful examinations made of the site of lesion, the associated nerves and the organs to which the nerves were distributed. In every series of cases in which experimental evidence was thus sought for the support of the osteopathic theory, the nerves showed congestion and inflammation at the site of the lesion, and the organs they supplied gave evidence of congestion, inflammation and disordered functions. An account of some of the results obtained by animal experiments follows:

DR. McCONNELL"S EXPERIMENTS

Dr. C. P. McConnell has experimented upon healthy dogs, producing slight displacements of the vertebrae and ribs and studying the effects produced. The following is a summary of the results announced in the first twelve cases:

"In nine of the twelve cases, inflammation of the nerves at the seat of the lesion was noticed and in one a nervous degeneration was manifest. In each case the diseased organs observed were under the control of the nerves coming off from that part of the spinal column in which the lesion was made.

Dog 1.—Showed a stricture of the small intestine.

Dogs 2 and 3.—Had spleens very much enlarged.

Dogs 3 and 4.—Became very sick.

Dog 5.—Lost flesh rapidly.

Dog 6.—Dissection showed an inflamed area in the stomach and an enlarged spleen.

Dog 7.—Became blind.

Dog 8.—Became blind.

Dogs 9-10.—Developed goiter.

Dog 11.—Dissection showed hemorrhagic inflammation of the kidneys.

Dog 12.—Died in three days with hemorrhage of the intestines.

Thus the osteopathic lesion theory has been demonstrated: First, by the cure of disease by the removal of lesions; second, by causing disease by producing lesions."—Journal of Osteopathy, May, 1906.

Since the experiments referred to above, Dr. McConnell and his associates have conducted experiments along similar lines on several hundred animals, gaining therefrom further scientific evidences of the effects of bony lesions in the production of disease.

His latest series of experiments have been relative to the influence of the specific spinal lesion as a causative factor in goiter.

The statistics cover about eight hundred cases of goiter in man and the experiments made upon twenty animals. Nine dogs having goiter were treated specifically. All showed reduction in size of the thyroid gland, some of the cases reaching normal. Two cases kept, as controls, under the same hygienic conditions did not show improvement. Nine dogs having normal thyroids were lesioned specifically and six thus lesioned developed goiter. This proves, both by the cure of goiter in humans and dogs by the correction of lesions and also by the development of goiter in dogs following the experimental production of lesions, the scientific basis for the osteopathic theory that the cause of goiter lies in the faulty mechanical relationships of certain vertebrae associated with the nerve supply to the thyroid gland.

DR. LOUISA BURNS’ EXPERIMENTS

Dr. Louisa Burns conducted a series of experiments at the laboratory of the Pacific College of Osteopathy to determine the immediate effects of bony lesions. The experiments were conducted upon animals and human subjects. The animals used for the purpose were cats, dogs, guinea pigs, and white rats. In every case the animal was given an anesthetic and none were ever permitted to regain consciousness after once losing it. No anesthetic was given the human subjects. These were intelligent men and women in good health and ignorant of the nature of the reaction to be expected from the experiment.

The experiments included lesions of the vertebrae, careful note being made of the immediate effects of the lesions experimentally produced. Cases were excluded from consideration where there was any doubt as to the lesion or any of the observations. One instance of lesion, namely, the ninth and tenth dorsal vertebrae, is here given to illustrate the effects repeatedly observed.

Animal tests showed that lesions of these vertebrae were followed by lessened peristaltic movement of the stomach and intestines; dilatation of the blood vessels of the stomach, intestines and pancreas; increase in the size of the spleen; accumulation of gas in the intestines, and sometimes the peristaltic movement of the intestines was reversed. In some cases, after the lesion had been maintained for some time, bile was found in the stomach.

The human tests showed that lesions of these vertebrae produced a lowering of the blood pressure, increased reaction time, noises of moving gas in the intestine and a sense of sleepiness. The accumulation of gas in the intestines sometimes caused discomfort, but there were no symptoms of nervousness or headache that appeared, although these discomforts were present when the lesions of the vertebrae higher up in the spine were experimentally produced.

The clinic records show that the diseases associated with lesions of these vertebrae are inflammation and dilatation of the stomach, inflammation of the colon, congestion of the spleen, catarrhal jaundice, and constipation.

The tests were carefully conducted and the recorded observations add scientific proof to the osteopathic theory.

Dr. Louisa Burns is now with the A. T. Still Research Institute. She has conducted several interesting series of investigations concerning the relationship of lesions to various diseases. She thus summarized the scientific proofs of Osteopathy in the Journal of Osteopathy:

"If the work of Dr. Still had included nothing more than the recognition of the relation between maladjustment of bones and other tissues to certain forms of disease, this alone is enough to place him first among discoverers in the field of medicine during the nineteenth century. That these slight misplacements, called "bony lesions," do act as efficient factors in the production of abnormal function is proven by the facts:

1. The examination of patients suffering from disease not due to local injury shows that there are bony lesions affecting the regions most closely associated with the nerve centers controlling the organs which are abnormal.

2. The examination of people in fairly good health may show that there are bony lesions affecting the nerve centers in certain parts of their bodies. In such cases it is found either that they are subject to malfunction of such organs, or it will be found later that these organs are more subject to infection, etc., than the rest of the body.

3. In persons who are sick, and in whom the bony lesion is found, the correction of the lesion is followed by as relief of the symptoms; and if there has been no destruction of the tissue, by return to health.

4. The examination of cadavers frequently shows the existence of bony lesions, and of abnormal visceral conditions associated with the related nerve center.

5. Slight and temporary bony lesions, experimentally produced upon human subjects, give rise to those changes in the pressure and circulation of the blood which initiate the beginnings of disease and the lowering of vitality.

6. Bony lesions experimentally produced upon animals are followed by circulatory and functional changes of the organs in closest central connection with them, and these changes are to be predicted from the location of the lesions produced. In anesthetized animals, the changes may be watched as they follow the production of the lesion.

The physiological effects of the bony lesions upon the visceral, vascular and skeletal muscles and the glands of the body are explained by the anatomical relationships of these structures.

DR. WHITING"S EXPERIMENTS

Dr. C. A. Whiting conducted a series of experiments on the influence of osteopathic manipulations upon the germ-destroying power of the blood. In a letter he summed up the result s of his work as follows:

"Of the little I have done, the most important seems to me to be the demonstration of the increase of phagocytosis (destruction of germs) as the result of mechanical stimulation. I feel quite safe in asserting that phagocytosis is increased to marked degree by physical stimulation. In the early days of opsonic work, our drug friends believed that the only way in which phagocytic powers of the blood could be increased was by the use of some vaccine. I feel quite certain, as the result of a considerable number of experiments, that we get the same result by mechanical stimulation of the liver, spleen, etc. If this belief is true, it is of great value to the physician, for not only does it guide him in his treatment, but it saves him from the necessity of introducing foreign serums into the body."

DR. DEASON"S EXPERIMENTS

Dr. J. Deason at the laboratories of the American School and at the A. T. Still Research Institute has been able to demonstrate in a scientific manner, by a large number of animal experiments, many of the practical workings of the osteopathic idea. Among the results secured with positive evidence by animal experimentation may be mentioned:

That lesion of the spine affects the function of the pancreas, liver and kidneys, and is often a controlling factor in the production of diabetes:

That spinal manipulations with fixation produce marked effects on the functional activity of the internal organs:

That lesions by nervous reflex cause disturbances in distant organs:

That lesions in the mid-dorsal region of the spine influence the secretions of the stomach and intestines:

That abnormal action of the intestines can be caused and ended by manipulation:

That certain manipulative work upon the spine causes certain definite changes in the blood pressure:

That the secretions of the liver and kidneys can be increased by manipulation.

These are some of the practical results of the research work along experimental lines which Dr. Deason has been able to demonstrate scientifically. In the next chapter Dr. Deason gives a summary of the work of the Research Institute.

To review in a word the scientific efforts made to test the claims of Osteopathy, we find that clinic records, spinal tracings, dissections, autopsies, the X-ray, and animal experimentation each contribute their share of demonstrable evidence in support of the theory of Osteopathy that structural abnormalities are a fundamental cause of disease and that the cure of disease is accomplished by the removal of the causes, i.e., by structural adjustment.

During the past five years while teaching in the American school of Osteopathy and since  coming to the A. T. Still Research Institute, by the aid of a number of assistants, we have been studying the principles of Osteopathy experimentally, and have, we think, determined some things of real value.

In much of our work we have used animals,--monkeys, dogs,cats, rabbits and guinea pigs,--for the purpose of studying the results of osteopathic lesions.  The animals are first normalized by keeping them under perfectly normal conditions for a number of weeks or months, and are observed very carefully.  They are then lesioned by placing them under complete ether anesthesia and producing a subluxation in the spine.  After this they are again carefully observed for a number of weeks or months and the results recorded.  Only those animals are used for such work which are found to be entirely normal in every respect.  After the animal has developed some disease or perverted physiological condition from the results of the lesion produced, it is killed by means of ether or chloroform and a careful study, both macroscopic and microscopic, is made of the various bodily tissues.

By this method of study we have found that nearly every organ of the body can be influenced by the effects of  bony lesions (subluxations) in different parts of the spine.  Such resulting conditions as abnormal physiological action and pathological changes of the stomach, liver, intestines, kidneys, spleen, pancreas, adrenals, etc., have been positively demonstrated many times.  A detailed account of this work would require too much space and would be uninteresting to anyone other than the physician or experimental scientist.  The results of this work on about one thousand animals confirms the findings of Drs. Burns, McConnell, Whiting and others who have done similar work.

The experimental work on dogs shows that the kidneys and liver can be affected mechanically.  By osteopathic manipulation of the spine, it was shown that production of urine by the kidneys could be greatly increased.  In some cases the increase amounted to more than one hundred percent.  Since the kidneys are the filters of  the blood it may be seen that the elimination of toxic substances from the blood may be accomplished by Osteopathic methods. This has been put to practical test by many osteopathic physicians since the results of the experimental work were published and has proven to be of actual practical value.

Similarly it was shown that the functional activities of the liver could be controlled. By measuring the amount of bile (counting the drops and by weighing) secreted in a definite time and then manipulating the segments of the spine from which segment of the spinal cord the nerves originate, which supply the liver, it was found that not only the amount was increased, but that it was higher in specific gravity. Thus we have definite evidence of the value of osteopathic therapy on the functions of the liver.

When any animals chosen for this work failed to normalize, i.e., if they were not found to be in perfect health in every way, they were not used but were treated osteopathically, and in most cases we were able to normalize such animals after this treatment. Our work on filariasis in monkeys is an interesting example of this. Fourteent months ago we received two dozen monkeys which had recently been imported from the tropics. All but one were found to be affected with filariasis, a disease somewhat similar to sleeping-sickness, caused by an animal parasite. Two animals died before the cause was discovered.

The affected monkeys were then divided into two groups.  Seven were treated by the best known medical methods and fourteen were treated osteopathically.  Of the seven treated by medical methods all died.  Of the fourteen treated osteopathically, ten recovered.  We kept a few of these to determine whether the recovery was temporary or permanent.  As yet none have shown any further signs of the disease but have grown much larger and stronger which shows that the cures are both complete and permanent.

It will be seen that our work differs from the work of most research workers in that we are studying the natural methods by means of which parasitic and bacterial disease can be cured rather than the methods of producing disease in animals and then treating the results by vaccines, serums, etc.

Another part of our work consists of making a more thorough and careful study of human anatomy by dissections.  It has been our purpose to dissect in such a way as to determine how we can best reach certain organs by manipulation and therefore correct abnormalities.  This work has also resulted in gaining some valuable information.  As an example of this we may cite the new method of treating catarrhal deafness.  It was found that the pharyngeal opening of the Eustachian tube (the tube which leads from the middle ear to the pharynx) was frequently closed by catarrhal inflammation of the nose and throat and that deafness and ringing in the ears might be a result.  It was Dr. J. D. Edwards, then a student in my classes, who put this information to practical test and it was he who did most to bring it before our profession.  During the past two or three years we have been working together on this problem and now many of our physicians are successfully applying this technique in practice.  While we have not as yet studied our cases sufficiently to know the exact percentage of cures, I believe that it is safe to say that we get favorable results in at least seventy percent of cases of catarrhal deafness.

Another part of our work has been the study by means of bacteriological methods of vaccines and serums and their effects.  We want it to be definitely understood that   Osteopahy as a profession or as a school of practice takes no stand for or against vaccination or serum therapy or any method of treating disease the value of which has been demonstrated.  Our physicians, however, have not been taken by the serum craze as has the medical profession, and this is because we are not without a reasonable and natural method of therapy.

The results of our study of smallpox vaccine showed that there was no such material on the market which did not contain various living bacteria which were dangerous.  From specimens of such virus prepared by two of the best known manufacturers in America we isolated more than thirty different kinds of bacteria, eighteen of which were pathogenic or disease-producing bacteria.  For the results of this work in detail we cite the reader to the Journal of Osteopathy for March, April, May and June 1911.

Some of our most recent work has consisted of the examination and testing of various nose and throat washes commonly sold on the market.  Of fifteen such preparations we have not found one that will kill the bacteria in the sputum when mixed with it for as long as an hour, nor do they seem to have any marked beneficial effect on the mucous membranes.  The above is only a brief summary of some of our work.  The detailed reports may be found in the Journal of the American Osteopathic Association and other journals.

I am greatly indebted to my co-workers in the A. T. Still Research Institute and others for assistance in this work, for without their valuable suggestions and assistance it would never have been accomplished.

Osteopathy is great because its merits are inclusive of a broad field.  Osteopathy is a system of healing, not alone a method of treatment.  It is a system or school because it has a distinctive and embracing etiology, diagnosis, pathology, and therapy.  Other schools are divergent on the therapeutic plane only.  Therapeutics can amount to but little if it is not based upon the other factors, and those factors consist of etiology, diagnosis, and pathology.  Thus the reason of an unstable and shifting therapy of the drug schools.  What will make a school of the healing art stable, consistent, and hence scientific is its etiology and therapy.  The latter, at best, is only a means to an end.  Osteopathy presents, logically and practically, this necessary fundamental based upon the bedrocks of anatomy and physiology.

Osteopathic teaching is revolutionary.  Old and accepted ideas were broken away from and an entirely new field of investigation was opened.

In the beginning, a condition was found in the patient; it was corrected and the result was health.  That was all the public asked.  One ounce of cure was worth tons of theory and they did not inquire into the means of their relief.  But adequately to teach Osteopathy a vast amount of original work had to be done.  Anatomy is anatomy but there is a vast difference in its application.  Physiology must be taught to mean something more than an interesting phenomenon.  Pathology had an unfilled gap between cause and effect which must be bridged.  The post-mortem had a great story to tell but an Osteopath must tell it.  A slide of degenerated tissue under the microscope is of interest, but why the degeneration?  It is described at length by the authorities but the causes and morbific changes are not carried out.  Obstetrics along strictly natural and physiological lines insuring both mother and babe against injury; Gynecology minus the knife and plus common sense; all these and more had to be shaped to teach the osteopathic student.  The archives of Osteopathy were empty a few years ago.  There was no precedent to follow and the ideas in teaching which had prevailed for centuries dominated.  All this is changed.  The colleges teach the science along strictly osteopathic lines, making the application of the truths which have escaped the notice of centuries of investigation.

There is a much discussed subject, just what is osteopathic and what is not.  Dr. C. M. T. Hulett, at a Greater New York Osteopathic Society meeting said:

“Every application, appliance, method or procedure used in treatment of disease may be classified under two heads.  If its effect is to modify the vital processes themselves, it is medical.  If its effect is to remove conditions which are interfering with processes, it is osteopathic.  Among the first are most drugs used for their physiological effect, much surgery, electricity, hot air, vibrators and similar devices.  Among the second are manipulation, germicides, regulation of diet, habits and life environments.  If the X-ray or Finsen light will kill the lupus or cancer germ the principle of their action is osteopathic.”

That is the best opinion on that much-mooted question I have ever seen and it is a guide-board for all who are in doubt.

The difference in the training of an osteopathic physician and a doctor of medicine is one of quality, not of quantity.

To the lay mind the perusal of the curriculum of an osteopathic and a medical college would indicate a difference in but one subject, that of therapeutics.  Naturally in the training of a doctor of medicine this covers drugs and their use in practice, while the osteopathic physician is trained in the application of the osteopathic theories to the treatment of disease.

The difference is greater than appears on the surface.  In the osteopathic college every subject is taught with the osteopathic or mechanical principle of the causation of disease coordinated with the instruction in anatomy, physiology, pathology, etc.  The incorporation of osteopathic principles begins with the first lesson in anatomy and ends with the last clinical demonstration.

The length of the osteopathic course is the same as the medical course:  four years of approximately eight months each.

The New York State Board of Regents requires that an institution recognized by them shall maintain a four-years’ course contemplating not less than thirty-four hundred hours.

The