Osteopathy

Osteopathy is a system of medicine that is distinct in a philosophical approach to patient care in health and in sickness. Doctors of osteopathic medicine (DOs) are fully-recognized physicians licensed to practice medicine in any of the recognized specialties in the United States and in Canada, as well as some other [Page 1303]countries of the world. Osteopathic practitioners in other parts of the world may or may not be physicians, but they also adhere to a patient-centered approach that utilizes osteopathic manipulation.

Osteopathy began in the middle of the United States in the State of Missouri by an itinerant physician, Andrew Taylor Still. Dr. Still was trained under the then-common system of apprenticeship and was licensed to practice medicine. He became increasingly discouraged with the ways in which typical allopathic medicine was practiced in the mid-19th century: lack of antisepsis; amputations; bloodletting; alcohol, opiate, heavy metal, and other dangerous medications; disease-focused treatments; and other unproven interventions. Dr. Still first expressed his frustrations and made a break from traditional medical practice on June 22, 1874, after having experienced personal losses with the deaths of several of his children and his first wife to disease.

He reasoned that physicians should focus on the patient and facilitate the inherent adaptive, self-heal-ing, and defensive mechanisms of the individual. Eschewing the typical approaches, his chief tool to accomplish his medical interventions was the use of manipulative techniques. By 1892, he had such success that he established a medical school, the American School of Osteopathy, in Kirksville, Missouri. Among his first students were former patients, family members, and allopathic physicians who were also frustrated with the typical heroic medical practices of the day. Dr. Still was permitted to grant an MD degree under the school's original charter that was granted by the State of Missouri, but he wanted to break with traditional practices, and so he chose to name his new approach “osteopathy” or osteopathic medicine.

Because manipulation was to be the primary tool, practitioners would have a “feeling for the bone.” Five women were among the inaugural class of students at his two-room building. The number of students and the physical size of the school rapidly grew as well as the number of schools developed by his followers. The initial satellites were established primarily throughout the Midwest of the United States and included colleges established in major cities such as Los Angeles, Des Moines, Kansas City, Philadelphia, and Chicago. An early graduate, J. Martin Littlejohn, returned to his native United Kingdom and established osteopathy in England. From there, it spread to the European continent, although it was primarily practiced by nonphysicians there.

The philosophical principles of osteopathy, although clarified over the last 100 years, have remained mostly unchanged:

• I.
  Structure and Function are interrelated

  • A.
    Normal

    • 1.
      Structure governs Function
    • 2.
      Function modifies Structure
  • B.
    Abnormal

    • 1.
      Abnormal Structure results in Abnormal Function
    • 2.
      Abnormal Function results in Abnormal Structure
• II.
  The Person (Body) is a Unit and is composed of an

  • A.
    Interaction of different systems

    • 1.
      Neurological
    • 2.
      Dermatological
    • 3.
      Musculoskeletal
    • 4.
      Hematological
    • 5.
      Cardiovascular
    • 6.
      Pulmonary
    • 7.
      Gastrointestinal
    • 8.
      Genitourinary
    • 9.
      Endocrine
    • 10.
      Immunological
    • 11.
      Behavioral/Psychological
  • B.
    Mind, Body, Spirit connections

    • 1.
      All of the components interact and influence each other
    • 2.
      There is sometimes difficulty separating what is cause or effect
• III.
  The body has an inherent ability to

  • A.
    Regulate itself

    • 1.
      Normal

      • a.
        Maintain systems
    • 2.
      Abnormal

      • a.
        Altered regulation
  • B.
    Adapt to changes that occur

    • 1.
      Normal

      • a.
        React to small alterations in environments

        • External
        • Internal
    • 2.
      Abnormal

      • a.
        Poor adaptation
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      • b.
        Inappropriate reaction
  • C.
    Compensate when regulation and adaptation cannot occur or inadequately occur:

    • 1.
      To inherent or developed inadequacies

      • a.
        Normal

        • Congenital malformations
        • Genetic
        • Functional inadequacies
      • b.
        Abnormal

        • Overcompensation
        • Undercompensation
        • Maintenance of adaptation past usefulness
  • D.
    Repair itself when damaged

    • 1.
      Normal

      • a.
        Tissue repair
    • 2.
      Abnormal

      • a.
        Scar formations
      • b.
        Adhesions
  • E.
    Defend against dangers from within and without

    • 1.
      Normal

      • a.
        Internal derangements

        • Abnormal cell formation (i.e., cancerous cells)
      • b.
        External invasions
    • 2.
      Abnormal

      • a.
        Inappropriate reaction to irritants

        • Recognition of host elements as “enemy” (i.e., autoimmune disease)
• IV.
  Disease/Dysfunction of the body

  • A.
    Is the interaction of the

    • 1.
      Host (person)
    • 2.
      Activating event

      • a.
        Endogenous
      • b.
        Exogenous
  • B.
    Disease occurs when the body is

    • 1.
      Overwhelmed
    • 2.
      Underprepared
• V.
  Rational treatment is based on the above principles

  • A.
    Treatment decision is based on proper

    • 1.
      History
    • 2.
      Examination
    • 3.
      Experience
    • 4.
      Knowledge
  • B.
    The function of the physician is to

    • 1.
      Facilitate the body's inherent capacities
    • 2.
      Minimize effects of disease

      • a.
        Endogenous alterations
      • b.
        Exogenous

        ...