History of Medicine and Osteopathy
By looking at a brief history of western medicine, you can see where Osteopathy fits.
Although no record exists, man may have used plants and diet as healing medicines. It is thought specific people within the tribe were given the role of a medicine man or Sharman.
Homer in the Iliad, describes the treatment of a wound where a doctor cuts an arrow from the thigh and spreading healing ointment on it.
Hippocrates is considered the father of western medicine. He described many conditions and treatments including the “clubbing” of the fingers for a patient with lung cancer. He categorised illness into acute and chronic and included in his case history that causes could be environmental.
Although his knowledge of Anatomy was poor, he had a good sense of a patients general state of health. His treatment of the 4 humours (blood, yellow bile, black bile and phlegm) was based on diet, exercise and manual therapy as well as some medicines. He treated the person as a whole, not just the disease.
Any lack of knowledge in Greek medicine was increased by the great surgeon Galen. He is even recorded to have performed brain and eye surgery!
Many of Galen’s anatomical mistakes were corrected during this period and included the study of neurology and the brain. An interesting fact is that thinking was thought to occur in the fluid filled ventricles of the brain (an important area for a cranial osteopath). The study of medicine had increased tremendously but prescribed treatments from doctors still consisted mainly of opium, quinine and metal based poisons.
The advances of modern medicine occurred in the 19th century where anaesthetics and antiseptic treatments were used. The main area of advancement was in sanitation and public nutrition. The theory that germs were the cause of infection replaced the previous idea of “bad air” or the Miasma theory.
The concept of infectious disease was proven by Robert Koch and Louis Pasture. A great rivalry existed between these two scientists and their respective countries. Pasture “won”, although many of Pasteur’s contemporaries felt that disease was not only caused by the germ, but also the health of the host organism (the body). Pasteur’s theory remained and spawned the pharmaceutical industry we know today.
Focusing on the host of the infection was starting to be recognised, although using expensive drugs to “fight” the infection is still a primary mode of action in western medicine. Osteopathy focuses primarily on the host.
Founded in 1874 Osteopathy places itself right in the middle of this shift in disease theory. It was a time of great change.
Darwin’s theory of natural selection (actually it was Wallace, but that’s another story) was published in 1859. Scientific knowledge of anatomy physiology had advanced, but treatment of a patient seen by a doctor still consisted of a limited array of drugs including: opium, arsenic, willow bark. Rest, broths and hot or cold drinks were prescribed.
Andrew Taylor Still was a Doctor during the American civil war. His father was a doctor in a Native American Indian reserve and the young A.T Still spent many years there learning from his father and the Indians.
Returning from the front line of war, he had treated many wounded soldiers and developed a sound knowledge of trauma medicine. He worked as a rural doctor administering the standard drugs to his patients, when his life changed dramatically after his wife and three of his children died from spinal meningitis. A.T Still devoted his life to find another way to treat disease.
He understood that man was made in perfect harmony with his environment and contained all the necessary drugs to heal itself. Disease could only occur if the structure of the person changed, thus allowing the germ to infect the “terrain” and spread. He vowed never to prescribe dangerous and ineffective medicines again, and set about learning how to adjust the human body to regain health.
His work was a great success, and by 1892 he founded The American school of Osteopathy in Kirksville, Missouri. He later stated that the title Osteopath didn’t fit the profession and distanced himself with the school as it had become less involved with the original principles. This was mainly due to Osteopath’s having to become licenced medical doctors, to be able to work.
Osteopath’s who set up schools in Europe, remained closer to the original philosophies of Still and the early teachers of Osteopathy. It is this form of Osteopathy which is taught and practised in New Zealand. Today, we are known as manipulators of bones for musculo skeletal problems, but our history is so much more. My hope is that Osteopathy can be a part of modern healthcare as a treatment of the complete system as it was intended over 100 years ago by the great man A T Still.
This was the golden period of modern medicine. Antibiotics were discovered in 1928, x-rays in 1895 and modern anaesthetics increased to being used in elective
surgery. Corticosteroids (steroids) in 1944 and the current theory of cancer. The Universal Health Service was founded between 1939 and 1941. The modern Doctor now had an array of useful medicines and the scientific knowledge and funding to back it up. Medicine had come of age.
Around this time, Osteopathy was under pressure to adopt these drugs and new scientific techniques and Osteopaths started to prescribe drugs (called mixers buy AT Stills). Osteopathy was not about fixing backs it was a system of health care complete with surgery and obstetrics and gynaecology. There was even an Osteopathic psychiatric hospital.
A good example of how Osteopathy worked as a system of health care, is to compare the death rates during the 1919 influenza epidemic between Osteopaths and allopathic doctors. In 1000 cases Osteopaths had a death rate of 2.25 and allopathic doctor of 50. This was also true of mortality in pneumonia out of 1000 cases osteopathy had a death
rate of 100 and allopathic medicine 350 (ref, Lengthening Shadow Of A T Still, by A Hildreth, page 420-421).
Founded by Daniel David Palmer in 1895, he had been a student of Osteopathy at the American Osteopathic School AT Still founded (the ASO). Palmer didn’t complete his training as an Osteopath but instead returned home to set up a Chiropractic school. Many chiropractors were jailed for practising at that time including Palmer.
The chiropractic school was then run by Palmer’s son B.J who ran it as a business, where the emphasis was on selling skills rather than the actual practice. “We manufacture chiropractors. We teach them the idea and show them how to sell it”.
Daniel Palmer voiced concerns on how the school was being run and tried to regain control of it. Chiropractors were able to gain a licence to practise in the USA, but were unable to prescribe medication or practice medicine.
In New Zealand today, chiropractors undergo a lengthy bachelor degree just like Osteopaths, and are regulated by the New Zealand Chiropractic Board. We have many similarities and neither profession will tolerate a merger so we are left with two similar modalities with different names. Confusing I know, but that’s how it is.
Like all manual therapies its routes are found in Greek physicians such as Hippocrates. The modern day founders of Physiotherapy, were 4 nurses from Great Britain who formed the Chartered Society of Physiotherapy in 1894. Otago, New Zealand, shortly followed in 1913 with a school of physiotherapy.
Physiotherapy increased in popularity with the polio outbreak of 1916, and during both world wars in the rehabilitation of injured soldiers. Today, you will find physiotherapists in all areas of the hospital and wider community. Physiotherapist treat similar conditions to Osteopaths, so again, we are closely related.
In the modern world of evidence based medicine, Osteopathy is unable to fund large trials to validate its successes. The profession is still under pressure to conform and become medicalised as it was over 100 years ago. I sincerely hope we don’t become mixers and that we can continue to treat the person not just the condition to remain truly