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“The doctor of the future will give little medicine, but will interest his patients in the care of the human frame, in diet and in the cause and prevention of disease.”
Thomas A. Edison
Although Thomas Edison talks (above) about the ‘doctor of the future’, manual medicine has a history dating back to the beginnings of human civilization. Accounts are found from the Egyptians, the Chinese, and in the writing of Hippocrates — the founder of Western medicine. Osteopathy as a system of manual medicine and health care was founded by the American physician Andrew Still (1828 - 1917).
Osteopathy’s principles involve the reciprocal relationship between the body’s structure (anatomy) e.g. muscles, bones and joints, and the body’s functions (physiology) e.g. the viscera and processes. This can be appreciated by looking at the nervous system in close proximity to the spine itself.
For more information about Andrew Taylor Still (1828-1917) the founder of Osteopathy, and an excellent introduction to early Osteopathy and the early American Osteopaths, there is an excellent bibliography 'A.T. Still From the Dry Bone to the Living Man' by John Lewis (published in 2012). This book is reviewed here, on this site, in the Bibliography Osteopathy section, where I give excerpts from the book, and a review:
From the book 'A.T. Still From the Dry Bone to the Living Man' by John Lewis (2012):
"Andrew Taylor Still had been an MD for ten years when a devastating personal tragedy convinced him to stop prescribing the crude drugs of his day and seek a more effective method of practicing medicine. Believing that there must be a better way to heal the sick than introducing toxic substances into the body, he embarked on a lifelong quest to decipher the riddles of health and disease, life and death. Combining the latest scientific knowledge with the revolutionary intuition that the body innately contains all the remedies needed for curing, he developed a drug-less method of healing effective across the whole disease spectrum."
Still defined osteopathy as:
"that science which consists of such exact, exhaustive, and verifiable knowledge of the structure and function of the human mechanism, anatomical, physiological and psychological, including the chemistry and physics of its known elements, as has made discoverable certain organic laws and remedial resources, within the body itself, by which nature under the scientific treatment peculiar to osteopathic practice, apart from all ordinary methods of extraneous, artificial, or medicinal stimulation, and in harmonious accord with its own mechanical principles, molecular activities, and metabolic processes, may recover from displacements, disorganizations, derangements, and consequent disease, and regained its normal equilibrium of form and function in health and strength."
For more about the history of Osteopathy, Andrew Still, and the early American Osteopaths, you could look at the 'History of Osteopathy' by Asa Willard, D.O.
One of the most famous to study Osteopathy from Andrew Still was John Martin Littlejohn. Littlejohn worked with Still over a number of years, and taught physiology at Kirksville.
Littlejohn, a native of Glasgow, went to America to seek a better climate for his poor health. Littlejohn began to teach soon after arrival, but his health declined. However, Littlejohn was fortunate enough to go to Kirksville to be treated by Andrew Still, who's fame by this time had spread. Littlejohn's health recovered, and he studied Osteopathy under Still, where he later began to teach physiology. Whilst Still's interest was anatomy, Littlejohn's was to look behind the skeleton to that invisible function - physiology. After leaving Kirksville, Littlejohn spent ten highly productive years in Chicago studying life and movement in the living body. During this time he laid down the foundations for Osteopathic technique and practice.
Littlejohn left America (his brothers continued to run the Chicago Osteopathic Hospital which he had founded) and returned to the UK in 1913. There he established the British School of Osteopathy, where he taught continuously until the outbreak of war in 1939. However, following Littlejohn's death in 1947 the curriculum of the the British School of Osteopathy (which is still a thriving Osteopathic educational institution) changed and moved away from the original Osteopathic principles as taught by John Littlejohn.
From the book 'Lectures on Osteopathy', Volume One, by John Wernham:
"on the importance of the meeting of Still and Littlejohn at Kirksville in 1897. With hindsight, it has become clear that having recovered his health at the hands of A. T. Still, Littlejohn became lecturer and student at the American School whereupon he began to broaden the concept of osteopathic philosophy to which Still responded with a total denial. Still, the practical man of bones and their engineering and Littlejohn, with an eye to the functional activity of the body gave rise to the inevitable clash between these two stalwarts of osteopathic history – and so they parted.
In 1900, the following year, the Littlejohn College was established in Chicago and it was here that the foundations of osteopathy were laid. During the next decade the theory became reality in the treatment from the hospital patient to the chronic condition until 1913 when the Dean returned to this country to continue his academic career in the British School of Osteopathy from 1915 until the outbreak of war in 1939. With the cessation of hostilities in 1945 and the gradual return to normal life, the Maidstone Osteopathic Clinic began to operate in 1947, the Institute of Classical Osteopathy in 1953 and the College much later in 1980."
(The reference, at the end of the last line, to 'the College much later in 1980' refers to the John Wernham College of Classical Osteopathy, in Maidstone, UK.) I was very fortunate to have studied (after my time at the London School of Osteopathy) at the John Wernham College of Classical Osteopathy, while John Wernham was still teaching.
To read more about both Andrew Still and John Littlejohn you could also look at this page.
Littlejohn's teaching was preserved and taught by John Wernman (1907 - 2007) (with whom I was privileged to to have studied when in the UK). This style of Osteopathy later became know as Classical Osteopathy.
John Wernham, who studied with Littlejohn, faithfully preserved his original Osteopathic teaching. Much of Wernham's writing (e.g. Lectures in Osteopathy Volumes 1 and 2, etc) is based around Littlejohn's practice notes. Here is an excerpt from Lectures on Osteopathy, Volume 1, by John Wernham:
"I have recently received a letter from a well known osteopath in which it is stated: 'That the Littlejohn lecture notes should be published for the benefit of young osteopaths.' I sent in return a copy of our book list with a reminder that we had been publishing Littlejohn's material for many years and intended to do so into the future. This is what is so extraordinary; here is the greatest academic we have ever possessed in osteopathy earning nothing but denigration in his lifetime and total eclipse after his death, still exciting the interest of a practitioner who never knew him but wants to introduce his lecture- notes to yet another generation."
To more fully understand the history of Osteopathy, you might want to look at some of the books I have reviewed in the Osteopathy Bibliography section. Perhaps the best book for the life history of Andrew Still and the origins of osteopathy is 'A.T. Still From the Dry Bone to the Living Man' (published in 2012) by John Lewis. However, there are several other excellent books (classics in their fields) including 'The Principles of Osteopathic Technic' (originally published in 1954) by Harrison Fryette, and some books published by John Wernman, including Lectures on Osteopathy Volumes One and Two. Much of John Wernham's writing is heavily influenced by Littlejohn, and Littlejohn's original osteopathy practice notes. Wernham remained faithful to Littlejohn's legacy, and to maintaining this original osteopathic teaching.
However, by the later years of the twentieth century (1990s) in the UK and elsewhere, Osteopathy was becoming increasingly medicalised and orthopaedic as it entered more into mainstream healthcare. There was diversification and fragmentation of Osteopathy, and new disciplines of a modern Osteopathy emerged and gained ground: Cranial Osteopathy, originally from Sutherland (who also studied with Andrew Still) and later cranio-sacral therapy (popularized by Updedger). Also Visceral Osteopathy (popularized by Jean Pierre Barral) became more prevalent.
William Garner Sutherland (1873 - 1954) who also studied with Andrew Still, and later developed what became know as Cranial Osteopathy.
However, we owe a great debt to John Wernham (1907- 2007) for preserving the original Osteopathy and staying true to Littlejohn's original teaching and Osteopathic principles. For more about this and, John Wernham's contribution, please see the Osteopathy Principles page.
“In therapy, first do no harm.
Life is short, art is long, the occasion fleeting,
Experience deceitful and judgement difficult.”
Hippocrates (400 BC)
This saying, attributed to Hippocrates, the so-called father of medicine, stresses the importance of non-harm. Hippocrates would have been familiar with 'physical therapy' or massage, as it was also used in his time. I think this advice is really cautioning the student or novice practitioner in the art of differential diagnosis and the clinical reasoning process (for we also have this in the Osteopathic model — albeit a musculo-skeletal differential diagnosis rather than a medical one). Hippocrates seems to be cautioning his readers (and students) 'to do no harm' and keep an open mind and high 'index of suspicion' — all good practice, and good in the clinical reasoning process.
The principle of non-harm would also in accord with the principles of Osteopathy, and especially the early Osteopathy of Andrew Still's time, where there was often great harm done by the poisoning from the crude drugs ( mercury, etc) of the mid nineteenth century. This was one of the factors that inspired Andrew Still to develop Osteopathy originally.
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