Osteopathy

"OSTEOPATHY. - According to its advocates, osteopathy is that system of the healing art which regards the structural integrity and adjustment of the mechanism of the body as the most important single factor in maintaining the organism in health, in contrast to the older systems which regard the chemical intake of the body as the most important factor. In other words, osteopathy is based on the recognition of the human body as a vital mechanism, a living machine, which, given wholesome physical and mental environment, good food, proper exercise, pure air and pure water, will be healthy, that is, will function properly, so long as all the cells and parts of that vital mechanism are in normal adjustment.. Osteopathy teaches that structural derangement of the body is the predisposing cause of disease. It causes functional perversion of the vascular and nervous systems, weakening the nutritional processes and lowering the powers of resistance of the body; on the one hand, producing congestion, either general or local, active or passive; on the other, depriving tissues of an adequate blood and lymph supply. This perversion impairs the rebuilding of cells after waste due to active function ing and retards the elimination of waste products through body drainage, thus making the body unable to withstand climatic changes or unhygienic and insanitary surroundings, and offer ing a hospitable medium for the invasion and propagation of pathogenic germs. For example, as Dr. Still, the founder of osteopathy (see below), said, " A disturbed artery marks the beginning to the hour and minute when disease begins to sow its seeds of destruction in the human body. The rule of the artery must be absolute, universal and unobstructed, or disease will be the result." If a machine is complete in its structure, and the structural relation of all its parts is perfect, it performs its function perfectly; if, however, it is not " plumb," if some of its parts are ill-adjusted, if friction is increased, it will not function properly - it will not perform its proper work. So it is with the human body. If the structural relations of the various cells, tissues and organs of this vital mechanism are in perfect harmony, and if there is an unobstructed supply of blood, lymph and nerve to all these cells and tissues, then the purposes for which these cells, tissues and organs are designed will be carried out; but if the structure is perverted in any manner the functioning also will be perverted. Integrity of mechanical structure determines the normality of functioning. That this structural perversion is the basic cause of functional disturbance or disease is a distinctive and fundamental principle of osteopathy.

Centuries old is the idea that man is a machine, and that his operations are dependent upon mechanical laws; but to Dr. A. T. Still is due the honour of recognizing the unity of the body and the law that any derangement of its mechanical structure is followed by disordered functioning or disease, and that the vital mechanism possesses the auto-protective power to restore normality of function, without pharmaceutical, chemical, electrical, or any other extraneous and artificial stimulation, as soon as complete alignment and adjustment of such derangements have been made. These structural derangements of the body are technically called " lesions." A lesion is defined as " any structural perversion which by pressure (or irritation) produces or maintains functional perversion." All the tissues of the body are subject to such perversions. They are produced by both external and internal forces. External causes are mechanical violence, such as falls, blows, strains, ill-fitting clothing and the like, and changes of temperature. Internal causes are postural influences, abuse of function, and nutritional disturbances.

A gross, frequent, palpable and easily distinguishable lesion is that of the sacro-iliac articulation. It is highly productive of functional perversions of the sciatic nerve, pelvic viscera, and the body equilibrium. Before Dr. Still's founding of osteopathy in 1874, anatomists described this as an immovable joint. He demonstrated the opposite by recognizing it as a movable joint, and correcting its derangements. This disturbance was among his first citations and teachings as an example of the osteopathic lesion. Only within the past two decades have other schools of medical practice recognized that this articulation is subject to this lesion and its resulting pathological disturbances. The more frequent, and consequently the more important, lesions are those of the bony, muscular and ligamentous tissues. Owing to their intimate mechanical relation with the nervous and vascular systems, particularly the vasomotors which control the rate of blood-flow, these tissues along the area of the spinal column are those most subject to lesions of far-reaching influence. Clinical experience also proves that a large majority of lesions are found in the spinal region. Hence the importance of maintaining the integrity of this area, both as a prophylactic and as a curative measure. And nowhere is it of such supreme importance as with children, subject as they are to the thousand-and-one stresses and strains of tumbling about from morning to night. Osteopathy teaches that nothing will contribute so much to the health of children as to see that they are examined every few months for the purpose of detecting lesions, just as they have their teeth examined by the dentist to detect lesions there. As contributive factors in the etiology of disease, osteopathy recognizes germs, abuse of function, unhygienic and insanitary surroundings, climate, etc.

Osteopathic diagnosis has but one aim, to find the cause. It includes the complete examination of the whole body and its excretions, especially the articulations and alignments of the vertebrae, ribs and pelvis. Symptoms are noted, and all chemical, microscopic, hygienic, sanitary, and other findings are studied to aid in determining the existing conditions of tissue, viscera and function. Of supreme importance, however, is the physical examination to discover existing mechanical tissue lesions. In this respect osteopathy stands alone among schools of medicine.

Osteopathic therapeutics has but one aim, to remove the cause. This may require the employment of one or more of many means. It may, and it usually does, consist in the specific manipulative removal of the lesion or structural perversion, by effecting tissue adjustments, which free the remedial anti-toxic and auto-protective resources of the organism itself; or it may consist in correcting hygienic, dietetic, environmental and psychic conditions; or in the application of operative surgery for fractures, lacerations, and the removal of abnormal growths or organs so diseased as to be daager ous to life; or it may be the administration of antidotes for poisons and other dangerous substances. In osteopathic therapeutics the fundamental principle is, " Find the lesion, adjust it and let it alone." Some confusion has arisen in the minds of those unfamiliar with osteopathic practice as to the exact nature of osteopathic treatment. It consists in specific correction by manual adjustment of the several tissues involved in the lesion and no others. This corrective work. should be of the highest technical order, and based upon knowledge of the tissues involved and their mechanical relations, both in health and in abnormal conditions. Some have confused it with massage. For this confusion osteopathists hold there is no justification. The principles of osteopathic treatment are as different from those of massage as are the principles of surgery. Nor does osteopathic treatment mean simply " bone-setting." Correction of bony lesions is a large and important part of the treatment, but osteopathy goes further. Whatever the cause osteopathy tries to find and remove it. If abuse of function is a contributive factor, that must be corrected. If there are insanitary surroundings, they must be removed.

Osteopathic prevention or prophylaxis comprises systemic examination for incipient lesions, and their correction before function becomes disordered; individual hygiene and right living; public education in so using the body as to avoid injury, and in sanitation.

Osteopathy teaches the self-sufficiency of the normal vital mechanism. In other than normal conditions this principle powerfully manifests itself; the hypertrophy of the heart muscle in valvular insufficiency, the healing of a wound, the recovery of the body from " light attack " diseases without any treatment, all are instances of the self-sufficiency of the body to repair pathological conditions, traumatic and otherwise. Every healed wound, every hunchback, every particle of cicatricial tissue, every adhesion, shows a successful effort of nature to heal disease, and bears further witness that only the severe and persistent impairment of the mechanism made complete repair impossible. The discovery of opsonins and antibodies and their efficacy, together with that of the active principle of the thyroid and other glands forming the internal secretions, is a mark of gradual recognition and acknowledgment of this self-sufficiency when normalized and mechanically stimulated to the maximum exhibition of its reparative and auto-protective processes. Osteopathy aims at so normalizing and stimulating the vital mechanism that it will manufacture in the necessary abundance its normal supporting and protecting chemical compounds.

Many osteopathic physicians specialize in certain branches, such as surgery, obstetrics, gynecology, defective and feeble-minded children, mental and nervous diseases, conditions involving the lymphatics, and eye, ear, nose and throat affections. The results secured through osteopathy with defective and under-developed children are such that judges in juvenile courts in many cities have designated osteopathic physicians to give these unfortunates professional care in a sincere effort to reclaim them before committing them to an institution. The success attending the efforts of those physicians specializing in nervous and mental diseases has been so marked that several sanatoria have been established for the exclusive care of persons so afflicted. The field of the eye, ear, nose and throat has, however, attracted by far the largest number of osteopathists who practise as specialists.

The special " technique " employed, variously known as " finger surgery," " finger technique," and " finger treatment," first developed and first given to the profession by an osteopathic physician in 1911, has been described as a system of digital manipulations of these regions whereby the physician adjusts the bony, ligamentous, nervous and muscular lesions, and breaks up any adhesions and masses of lymphoid tissue that interfere with drainage and with ventilation in any of the apertures, and by such technique restores the normal functional activity of the parts. This method was first used in catarrhal deafness, but is now employed in a number of other pathological conditions of these organs. Catarrhal deafness, hay fever and tonsillitis are the diseases most amenable to this treatment.

Osteopathic practitioners soon felt the need of institutional care for certain kinds of both acute and chronic pathological conditions. This need was all the more important on account of their being denied the opportunity of caring for their patients in the existing institutions controlled by the dominant school of therapy. Therefore, within recent years a number of general hospitals and numerous sanatoria under control of the osteopathic profession have been established.

Much excellent experimental research has been done by members of the profession under the direction of the A. T. Still Research Institute at Chicago. The work is chiefly along the line of osteopathic fundamentals, such as the production of lesions; the study of perverted function and the pathological conditions resulting therefrom; the correction of the produced lesions, and the study of the results following such corrections. These experiments, through clinical observations and post-mortem dissections on various animals, have demonstrated, among other things, that when a spinal lesion is produced, pathological changes in the tissues of the various viscera involved result (for example in that of the stomach, kidney, liver, intestines, pancreas and thyroid gland); and that abnormal functioning of these viscera also results (for example diarrhoea, constipation, nephritis, glycosuria, increased susceptibility to infection, and formation of goitre). The experiments have further demonstrated that the correction of the produced lesion is followed by a return to normal functioning. The produced lesions also showed profound pathological changes in the vascular mechanism of the posterior ganglion, the cells of the grey matter of the cord, and in the sympathetic ganglia, all of which affected their functioning. The experimental and clinical use of radiography in research and practice has demonstrated the existence of bony lesions and their non-existence following osteopathic adjustment.

The founder of osteopathy, Dr. Andrew Taylor Still, was born in Virginia Aug. 6 1827, and died at his home in Kirksville, Mo., Dec. 12 1917. He was a practising allopathic physician at the beginning of the American Civil War, served as a Union officer during that struggle, and at the close of the war returned to his home in Kansas and resumed the practice of his profession. Gradually his confidence in the efficacy of drugs as a means of healing weakened, and his faith in the inherent curative power of the body strengthened, until June 22;1874, when he publicly announced that he would henceforth discard the use of drugs as a curative measure and would dedicate the remainder of his life to aiding nature in the alleviation of disease by the mechanical readjustment of the disordered body. The American School of Osteopathy was opened at Kirksville, Mo., in 1892. There were in 1921 over 7,000 graduate practitioners of osteopathy in all parts of the world.

In addition to the school at Kirksville, there were in 1921 six others in the United States devoted to the teaching of osteopathy: The Philadelphia College of Osteopathy at Philadelphia; The Des Moines Still College of Osteopathy, Des Moines, Ia.; The College of Osteopathic Physicians and Surgeons, Los Angeles, Calif.; The Chicago College of Osteopathy, Chicago; The Massachusetts College of Osteopathy, Boston; and The Kansas City College of Osteopathy and Surgery, Kansas City, Mo. The student enrolment is second only to that of the allopathic colleges. The matriculant must have had at least a four-year high-school course or its equivalent. The curricula of the osteopathic colleges embrace all the subjects taught in other medical schools, except " Materia Medica," in place of which there is included " Principles and Practice of Osteopathy " and " Osteopathic Therapeutics." The course of study is four years of at least eight months each spent in actual attendance in one of the above recognized colleges. Osteopathy was by 1921 recognized and regulated by law in 47 states of the United States. The one remaining state, through court decisions, makes its practice legal. There is an international organization, the American Osteopathic Assn., having some 3,200 active members; an osteopathic association in each state in the Union; associations in Canada; the New England Osteopathic Assn., the Western Osteopathic Assn., the Eastern Osteopathic Assn., the South Atlantic States Osteopathic Assn, Osteopathic Women's National Assn., a British osteopathic association, the Academy of Osteopathic Clinical Research, and the American Society of Ophthalmology and Oto-Laryngology. There are io or 12 magazines and periodicals published by the profession.

(G. W. RI.)

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