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“Dammit, He Cures Them”: The Historical Context of Early Osteopathy and Its Relevance for

Osteopathic Medicine Today

Core Principle 2: The fundamental principles and philosophies that underlay the early practice of
osteopathy.

Word Count: 2,995

Author: Leslie Mae-Geen Ching, OMS-III

Submitted May 26, 2009


Ching 2

Ninety per cent. of the people living in America do not know anything of the trials and realities of a
Western pioneer’s life…The brain and energy of that day are mostly among the forgotten dead, but they fill
the graves of some of the great minds of America…They gave up their comforts for the benefits of the
generations to follow, lived on but little, stood guard all the time until schools and civilization were planted
in our wild country, and began the work of educating the minds to live another kind of life.
–Andrew T. Still1
 
Introduction

The origins of osteopathy are not well understood by today’s osteopathic physicians. Osteopathy
was originally conceived as a system of medicine with three aspects: science, philosophy, and
art. Osteopathy was not defined by manipulation, although that was a large aspect of treatment. It
is informative to examine how the historically contemporary culture of America, especially
frontier values, shaped the early practice of osteopathy and to compare that to today’s culture, in
order to analyze the identity problems confronting the profession today. It may help to put early
osteopathy in sociocultural and philosophical context. An implicit criticism that many physicians
today have is that osteopathy as a system is “unscientific.” But that is only true if one uses an
Enlightenment-derived definition of science, which is not the only legitimate definition of
science that can exist. Early osteopathy will be compared to other practices of medicine for
illustrative purposes.

A complete understanding of osteopathy cannot be divorced from the time and culture it was
developed in. If it can be understood and respected within its original context, then one may be
able to understand what it can do in the context of today’s world.

Osteopathy Originating as a Triune System

Osteopathy was originally conceived of as a system based on discrete facts (the science), with
the practice extrapolated from these facts (the philosophy) by the practitioner to fit the individual
patient and his or her unique presentation (the art).2 For every patient who presents with
pneumonia, there will be just as many different approaches to treat the patient.3 As Charles O.
Fleck, DO, stated, “There will always be art in the use of hands for interpreting and correcting
structural irregularities…It will allow for varying degrees of individual reaction to structural
disturbance and other variations found…”4

It is important to keep in mind that although manipulation was an integral part of early
osteopathy, it was not considered to be the defining aspect of the osteopathic approach for every
patient.5 Carl P. McConnell, DO strikes an emphatic note: “The osteopathic physician who, in
every case he treats, bases his therapeutics upon manipulation alone, is a dangerous physician. In
fact, he is not a physician, not an osteopath, but simply a manipulator. This is the osteopathic
character who brings disrepute upon the science.”6 7
Ching 3

Frontier Influences on Osteopathy

The American frontier was a stark place where people either did what was necessary or they
died. It was also where Andrew T. Still, MD and many other early osteopaths were born and
raised. The principle philosophies that were the foundation of early osteopathy were ones that
were fostered in the frontier culture: self-reliance, continuous inquiry and problem-solving, an
empiricial study of and respect for nature, and a realization that although man could strive, God
was the ultimate force in the world.

Pragmatism and Self-Reliance

Dr. Still and other early osteopaths were quintessential American pragmatists, as were many
people on the frontier. If something didn’t work, then they tried to figure out what was wrong
with the existing model or build a superior model, using what they had. One can see this theme
throughout Dr. Still’s Autobiography: e.g., inventing a new type of butter churn that was much
more efficient through studying the food chemistry of butter.8

When it became only too clear that the contemporary model of medicine was ineffective after his
children died from meningitis despite the best medical care available, Dr. Still was determined to
find a better way. He tried to build a model of medical care that yielded better results with fewer
side effects than the existing model of medicine and health by using the things he had: his hands
and brain. He diligently studied anatomy and relating that to what was known of physiology and
functional anatomy at the time.

When he began teaching students, he encouraged this type of self-exploration of fundamental


principles of anatomy and physiology. It was the student’s obligation to make the connections
between theory and treatment, with guidance from the more experienced; to constantly “dig on.”
A panel at the 1957 AAO Convocation discussed what osteopathic education should be obligated
to do for society; one of its recommendations was as follows:

We need to help [our students] develop for themselves not some rigid definition of what the limits
of osteopathy are, but the direction in which it must continually progress, the possible directions
in which this profession can continually improve the practice of the healing arts and the care of
human health…That is one thing to which all our colleges need to give attention, the development
of a spirit of inquiry, of pioneering.9

The panel members make it clear that osteopathy is not a defined ideological box but a practice
of medicine that every individual practitioner renews in the process of continuous questioning.
This is the idea of osteopathy that is closest to the original sense: not a static idea, but one that is
in continuous flux, matching the demands of each patient and each practitioner.

Bottom-Up Learning and Students of Nature

Many people on the frontier were of necessity self-taught tinkerers. The accumulation of
knowledge was therefore of a “bottom-up” orientation: they acquired knowledge of a system by
Ching 4

understanding the intricacies of structure and function and then constructed a working model to
explain the system.10 They kept what they knew of anatomy and physiology always in mind as
the basic framework to analyze a situation.11 Early osteopaths were also observers and students
of nature, as were many allopathic doctors of the time12: as Dr. Still stated, “The osteopath who
succeeds best does so because he looks to Nature for knowledge and obeys her teaching.”13

Osteopathy was not intended by Dr. Still to be a system that could be understood or utilized just
by memorization or book learning: “Osteopathy cannot be imparted by books. Neither can it be
taught to a person intelligently who does not fully understand anatomy from books and
dissection.”14

It was not intended to be a system of treatment that was given whole to a student by virtue of
paying fees. Instead, the student was expected to find the meaning in the system by one’s own
“diligent and intellectually honest”15 efforts. As Dr. Still put it, “You must learn that neither
osteopathy nor its application to the patient is something that can be passed around on a platter;
one must delve and dig for it themselves.”16 17

One can see, therefore, how the expectations of early osteopathic education demanded a self-
motivated and observant student who attempted to construct a system for oneself, based on
anatomy, physiology, and osteopathic principles.

Religion

One of the philosophical touchstones of early osteopathy was God’s place in the world: this was
taken for granted by Dr. Still and other early practitioners. Dr. Still did not even take credit for
osteopathy, instead giving credit to God.18

The fundamental idea was that if God were perfect and He could only create perfect things, then
God’s creations must have the capability for self-healing.

I decided then that God was not a guessing God, but a God of truth. And All His works, spiritual
and material, are harmonious. His law of animal life was absolute. So wise a God had certainly
placed the remedy within the material house in which the spirit of life dwells. With this thought I
trimmed my sail and launched my craft as an explorer.19

For these early osteopaths, such as Harrison H. Fryette, DO, it was the doctor’s responsibility to
find the health in the body and remove the obstructions to the expression of health, with God’s
assistance.

Doctor Still’s philosophy was not a philosophy of anatomical adjustment. He discovered and
applied that science which was revolutionary, but his philosophy was that the Divine essence in
the body cured the body and that all any physician ever can do is harmoniously adjust the grosser
parts within the body and the body and the mind with its environment so that it can function. We
can do no more. We can only go just that far and after that we can go home and say, “Now God,
you take over, you have to do the curing.”20
Ching 5

Because of this philosophy, many early works have an overtly religious tone to them.21 This
makes for uncomfortable perusal by those who are not so religiously inclined and makes them
more likely to dismiss these early writings by Still and others. This would be a mistake because it
ignores the cultural milieu of the time that brought forth osteopathy. Osteopathy cannot be
divorced from the historical era it developed in.

Comparison with Historically Contemporary Philosophy

As an illustration of this era, one might make the comparison between the historically
contemporary and influential American Transcendentalists and early osteopaths. Both groups
observed nature with a religious context. The writings of Ralph Waldo Emerson and others were
liberally sprinkled with allusions to both God and nature and emphasized the spiritual aspect to
nature and to living:

Prayer is the contemplation of the facts of life from the highest point of view. It is the soliloquy
of a beholding and jubilant soul…as soon as the man is at one with God, he will…then see prayer
in all action. The prayer of the farmer kneeling in his field to weed it, the prayer of the rower
kneeling with the stroke of his oar, are true prayers heard throughout nature...22

They emphasized a broader role of man than just the rationalist: they also emphasized man as a
part of the natural world. To them, man was a part of God’s creation, not the pinnacle.

These roses under my window make no reference to former roses or to better ones…they exist
with God to-day…But man postpones or remembers…He cannot be happy and strong until he too
lives with nature in the present, above time.23

This may be a valuable comparison to make to better understand the social context that
osteopathy arose in. Osteopaths who spoke fervently of God’s role and of the wisdom of God
and nature and of the importance of personal striving were not frontier fanatics. These thoughts
were deeply rooted expressions of the zeitgeist: as demonstrated, they stretched from highly
intellectual areas around Boston to the small towns of Missouri.

Historical Context of Osteopathy

The effects of the era in history that osteopathy was founded can clearly be seen in early
writings. Osteopaths were expected to learn much about the system by self-exploration. They
were expected to create their own working model of how the body functions, how to find the
health in the body, and how to bring it forth when the disease state was present. Osteopathy’s
philosophy is based on the idea that God (or nature) has superior wisdom to man. Osteopathy, as
a system of treatment, cannot be fully appreciated without all of these factors in mind.

Early Osteopathy in Relation to Other Philosophical Systems

Early osteopaths were empirical scientists.24 This means that they made causative arguments
based on observation, which are then refined and tested against further observations.25 This type
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of empirical study is one of the oldest forms of scientific observation and one that is especially
pragmatic: as Dr. Still noted, “An osteopath must be a man of reason and prove his talk by his
work. He has no use for theories unless they are demonstrated.”26 This pragmatism is what
enables eons-old systems of medicine, such as Chinese medicine, to be practiced today:
generations of people have tested the system and found that it has consistently worked.27

Describing osteopaths as “empiricists” does not imply that they were unscientific. Early
osteopaths constantly refined their models on an individual basis and if a model was seen to hold
intrinsic truth, then it became widely disseminated: e.g., William Garner Sutherland, DO and
osteopathy in the cranial field. Compare this type of science to this description of Chinese
medicine: “[Chinese medicine] does resemble science in that is it grounded in conscientious
observation of phenomena, guided by a rational, logically consistent, and communicable thought
process. It has a corpus of knowledge with standards of measurement that allow practitioners
systematically to describe, diagnose, and treat illness…”28 Both liberally use systematic
observation to build an internally coherent medical system.

Osteopathy and Chinese medicine are examples of systems of thought that differ in one very
important way from today’s predominantly rationalist system: they make no attempt to explain
the innate mystery of life, a philosophy that is also called vitalism. Although early osteopaths,
such as Dr. Fryette, felt that man had the intrinsic ability to heal himself, they also realized that a
large part of this process was unintelligible. 29

In studying the vital processes of the body, we are dealing with what we call nature, life, vital
essence or as I prefer to name It, the Divine essence. This may, and probably does, result simply
from chemical action, but it is a Divine, inscrutable essence just the same.30

Therefore, the idea that they might not be able to elucidate every little detail did not disturb
them: efficacy was primary. It was enough that the model worked and produced good results,
which was also enough for their patients: “The story is that Dr. Smith [the future anatomist at
ASO] wanted to know why [Still] wasn’t run out of town, to which the druggist is said to have
replied, ‘Dammit, he cures them.’”31

This philosophy of vitalism and empiric truth puts these systems at odds against allopathic
medicine, which is grounded in the Enlightenment approach of reason and experimentation.32
Rationalist systems are philosophically reductionist: they argue that man can theoretically reason
out all possible knowledge, where “the criterion of the truth is not sensory but intellectual and
deductive.”33 Another difference of allopathic medicine, as social scientist M. Foucault
describes, is that it is based on a theoretical conception of normality, with the goal being to
transform the “abnormal” to “normality.”34

Allopathic and osteopathic medicine can be therefore seen as disparate poles in a spectrum of
approaches to science.35 36 Allopathic medicine may seem to be more “scientific” because we are
raised today in the Enlightenment tradition of the “scientific method,” with its hypotheses,
Ching 7

experiments, and statistical analyses. However, osteopathy and other approaches to knowledge
are not any less “scientific” because their knowledge base is observation rather than
experimentation. One system attempts to describe the world with hypotheses that are tested with
systematic experimentation, which again is used to refine the theory; the other attempts to
describe the world with a series of observations that is used to construct hypotheses, which are
retested by observation, and further refined. One system has a definitive endpoint; the other is a
process of continuous discovery. Can one approach be deemed more legitimate than the other?

Conclusion: Inquiries for the Present and Future

Over time, of course, American culture has changed. Even religion, the usual harbor of the
power of the inexplicable, became something most people observed when convenient. Nature
itself became an inconvenience that many people rarely experienced.

Perhaps it is not so surprising, then, that osteopathy as a science, philosophy, and art is no longer
widely appreciated even among DOs. In this rationalist and reductionist culture of today,
“technics” are an easy shortcut and make their own kind of intrinsic sense.37 One could build a
practice on “osteopathic manipulative medicine” with very little idea of “osteopathic philosophy,
practice, and principles,” or, the science, philosophy, and art of osteopathy.

The question of why osteopathy should exist has always been present. It is a system that is rooted
in a sense of pragmatism, self-reliance, and vitalism that was common on the American frontier
in the late 1800s and is not so common now. So the question becomes two-fold: can osteopathy
be practiced in something approximating the original sense in the America of today? And, what
in today’s American culture demands the presence of osteopathy and the development of
osteopaths?

For these questions, there is an answer if we as a profession are truly searching for a better
plow,38 whether that takes us closer to the original spirit of osteopathy or elsewhere. Dogmatism
on behalf of osteopathy or evidence-based medicine is of no use if patients are not helped. It
behooves us as a medical profession to be pragmatic: to honestly inquire how people are best
served and to bend our efforts to that end, no matter where it may take us. If there is no demand
for the osteopathic approach, then there is no reason for the profession to exist. However, if even
some patients are best served with a judicious combination of osteopathic treatment, medicine,
and/or surgery, then we should seize the opportunity to broadcast how our approach to medicine
is truly different and make sure that our profession is trained to be able to deliver this different
approach.

This questioning process requires a long look at the heart of our profession and what it means to
each individual on the part of all those who call themselves doctors of osteopathic medicine.39 It
requires a return to the self-exploration of early osteopathy. Every doctor of osteopathic
medicine does not have to be Christian and pragmatic and self-reliant and an observant student
of nature and to practice manipulation on every patient; however, each doctor of osteopathic
Ching 8

medicine should be well-founded in how and why one is “osteopathic.”40 41 The final thoughts on
this issue justly belong to Dr. Fryette for his pithy summary of osteopathy and joyous look to the
endless horizon of possibility:

The philosophy of osteopathy is really the philosophy of life. The philosophy of osteopathy is,
therefore, the study and knowledge of the principles that cause, control or explain the facts and
events of life as they pertain to the human organism. It is self evident that this is a philosophy that
is impossible to completely understand, because it is impossible for the human organism to
completely comprehend itself. However, the mere fact that we have here a problem incapable of
solution makes it a constant challenge and doubly interesting.42
Ching 9

Acknowledgements

The author would like to thank the primary influence on this paper, Richard G. Schuster, DO, for his
support and guidance. No less would she like to thank the many osteopaths she has shared time and space
with and others whom she has met through their writings: they have been as lights in dark places. She
would also like to thank her parents for their helpful critique and support. For all of these special people,
the DOs who are looking for a better plow, and all of our patients:

“The Road goes ever on and on,


Down from the door where it began.
Now far ahead the Road has gone,
And I must follow, if I can,
Pursuing it with eager feet,
Until it joins some larger way
Where many paths and errands meet.
And whither then? I cannot say.”
 
                                                                                                                         
1
Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p 26-8.
2
Another way of explaining this relationship is: “The execution of the philosophy through the lens of science is the
art.” Personal communication. RG Schuster. April 12, 2009.
3
Compare this to Chinese medicine: “Yet Chinese medicine also demands the artistic sensitivity of synthetic
logic—always aware that the whole defines the parts and that the pattern may transform the significance of any one
measurement within it…This artistic sensitivity allows the physician to stay in touch with subtle refinements of
meaning, to discern shades of significance in human and behavioral signs; but, most important, it allows awareness
of the process that exists around and between linear measurements.” Kaptchuk TJ. The web that has no weaver:
understanding Chinese medicine, 2nd edition. New York, NY: McGraw-Hill; 2000. p 19.
4
Fleck CO. Osteopathy and manipulation. American Academy of Osteopathy Yearbook. 1940: 3.
5
However, this can often be contorted to support not using manipulation at all. (See Brown JM. “Intent to teach”
and pay to play in osteopathic medical education [Letter to the Editor]. Journal of the American Osteopathic
Association: 109(4), April 2009; 211-2.) As William A. Kuchera, DO points out, “Of course osteopathy is more than
manipulation, it is an entire system of patient care; but this phrase becomes an excuse for practicing an allopathic
model of care, paying lip service to the musculoskeletal system or managing it only through exercise prescriptions
or when it is primarily injured…I, like most of you, have never been able to remove osteopathic diagnosis and
manipulation from osteopathy; it is a means of accomplishing our philosophy, discovering clues to disease and even
treating patients with systemic problems…” Kuchera WA. The triune profession: Thomas L. Northrup lecture, 1992.
In: The Northrup book, Volume II, editor HH King. Indianapolis, IN: American Academy of Osteopathy; 2009. p 48.
6
McConnell, CP. Possible injuries from misapplied or over treatment. Journal of the American Osteopathic
Association. 1903; 3: 71-7. Cf: Schuster RG. “Who are you?”: A question of osteopathic identity. Family Physician.
April 1998; 2: 4, 8-9; May 1998; 2: 4-9, 17.
7
Dr. Fryette describes the paradigm as follows: “If a thing is physiologic it is osteopathic. If it is not physiological it
is not osteopathic. Osteopaths are not restricted to manipulation but they are restricted to physiological
principles.”Fryette HH. An analysis of osteopathic problems. American Academy of Osteopathy Yearbook. 1946: 70.
8
Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p 92-3.
Ching 10

                                                                                                                                                                                                                                                                                                                                                                                                       
9
The basic responsibilities of osteopathic education to society (panel discussion). American Academy of Osteopathy
Yearbook. 1957: 32.
10
Dr. Hoover describes it as follows: “Manipulation is not subject to standardization as is surgery, drug therapy and
other therapies…It has been difficult to teach and when learned has required a great deal of practice and concerted
thought to develop it into an effective and dependable therapeutic agent.” Hoover HV. How and why I apply the
osteopathic principles in practice. American Academy of Osteopathy Yearbook. 1959: 71.
11
The commonly used references to osteopaths as “mechanics” and “engineers” emphasize this relationship: both
groups have a sound understanding of the structure and function of a machine and know how to get it back to good
working order again. “If a mechanic is so particular to inspect every part and principle belonging to a steam engine
for the purpose of getting good results, can you as an engineer omit any bone in the body and claim to be a
trustworthy engineer?” Still AT. Osteopathy, Research & Practice. Kirksville, MO: The Journal Printing Co; 1910.
p 24.
12
In fact, this was also an approach that was common to medicine prior to the nineteenth century (or, prior to the
Industrial Revolution). As social scientist M. Foucault, wrote: “The [medical] clinic demands as much of the gaze as
natural history. As much, and to a certain extent, the same thing: to see, to isolate features, to recognize those that
are identical and those that are different, to regroup them, to classify them by species or families. The naturalist
model, to which medicine had been partly subjected in the eighteenth century, remained active…” Foucault M. The
birth of the clinic: an archaeology of medical perception. New York, NY: Vintage Books; 1994. p 89.
13
Still AT. Osteopathy, Research & Practice. Kirksville, MO: The Journal Printing Co; 1910. p 13.
14
Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p 192-3.
15
Cathie AG. Integration of osteopathic principles into the teaching of the basic sciences. American Academy of
Osteopathy Yearbook. 1952: 63.
16
Heatherington JS. Stir what you’ve got: Thomas L. Northrup Lecture, 1990. In: The Northrup book, Volume II,
editor HH King. Indianapolis, IN: American Academy of Osteopathy; 2009. p 39.
17
Dr. Fryette observes: “The principle of osteopathy is simple, as all great truths are simple. Its application is not. It
requires infinite pains. ‘As ye labor, so shall ye reap.’” Fryette HH. The simplicity of osteopathy. American
Academy of Osteopathy Yearbook. 1938: 15.
18
Dr. Still notes: “I do not claim to be the author of this science of osteopathy. No human hand framed its laws; I
ask no greater honor than to have discovered it.” Still AT. Autobiography of AT Still, revised edition. Kirksville,
MO: Published by the author; 1908. p 371.
19
Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p 88.
20
Fryette HH. What does osteopathy mean to you? American Academy of Osteopathy Yearbook. 1947: 62.
21
E.g., “The intelligence of Deity is unquestionable; His law unalterable. On this law is the science of osteopathy
founded…” Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p
288.
22
Emerson RW. Self-reliance. In: The spirituality of the American transcendentalists, editor CL Albanese. Macon,
GA: Mercer University Press; 1988. p 120-1.
23
Emerson RW. Self-reliance. In: The spirituality of the American transcendentalists, editor CL Albanese. Macon,
GA: Mercer University Press; 1988. p 116.
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24
‘Empiricism’ partially derives from a more specific classical Greek and Roman usage of empiric, referring to a
physician whose skill derives from practical experience as opposed to instruction in theory.
http://en.wikipedia.org/wiki/Empiricism
25
Also see Gaines E and Chila AG. Communication for osteopathic manipulative treatment (OMT): the language of
lived experience in OMT pedagogy. Journal of the American Osteopathic Association. March 1998; 98(3): 164-8.
26
Still AT. Osteopathy, Research & Practice. Kirksville, MO: The Journal Printing Co; 1910. p 6.
27
“Based on ancient texts, [Chinese medicine] is the result of a continuous process of critical thinking, as well as
extensive clinical observation and testing. It represents a thorough formulation and reformulation of material by
respected clinicians and theoreticians.” Kaptchuk TJ. The web that has no weaver: understanding Chinese medicine,
2nd edition. New York, NY: McGraw-Hill; 2000. p 3.
Compare this to: “Osteopathy is a process of reasoning.” Willard A. The application of the principles of osteopathy.
American Academy of Osteopathy Yearbook. 1940: 16.
28
Kaptchuk TJ. The web that has no weaver: understanding Chinese medicine, 2nd edition. New York, NY:
McGraw-Hill; 2000. p 18.
29
Compare this to Emerson: “In all animal and vegetable forms, the physiologist concedes that no chemistry, no
mechanics, can account for the facts, but a mysterious principle of life must be assumed, which not only inhabits the
organ, but makes the organ.” Emerson RW. The method of nature. Accessed at
http://www.emersoncentral.com/methnature.htm on April 25, 2009.
30
Fryette HH. What does osteopathy mean to you? American Academy of Osteopathy Yearbook. 1947: 62.
31
Chiles HL. The founding and development of osteopathy as I recall it. American Academy of Osteopathy
Yearbook. 1947: 14.
32
In fact, the Transcendentalist movement began as opposition to the Lockean rationalism that had permeated the
Unitarian church. “Their revolt again and again witnessed to the barrenness and coldness they found in the rational
message of their church…[Emerson] called Unitarianism an “icehouse” with “coldness continually increasing,” and
he castigated the preaching of one minister as “the most ominous shaking of Unitarian husks & pods out of which all
corn & peas had long fallen.”” Albanese CL (ed). The spirituality of the American transcendentalists. Macon, GA:
Mercer University Press; 1988. p 5.
33
http://en.wikipedia.org/wiki/Rationalism
34
Foucault M. The birth of the clinic: an archaeology of medical perception. New York, NY: Vintage Books; 1994.
p 35.
35
Dr. Stiles describes the osteopathic-allopathic dichotomy in terms of the hygeian and asclepian schools of
medicine, both of which are Western in origin. Stiles EG. Conflicting visions: Thomas L. Northrup Lecture, 1996.
In: The Northrup book, Volume II, editor HH King. Indianapolis, IN: American Academy of Osteopathy; 2009. p 72.
36
Western medicine was not always this way. Foucault describes the earlier system of medicine as being remarkably
similar to early osteopathy: “Generally speaking, it might be said that up to the end of the eighteenth century
medicine related much more to health than to normality…it referred…to qualities of vigour, suppleness, and
fluidity, which were lost in illness and which it was the task of medicine to restore. To this extent, medical practice
could accord an important place to regimen and diet...” Foucault M. The birth of the clinic: an archaeology of
medical perception. New York, NY: Vintage Books; 1994. p 35.
37
Even in its early stages, osteopathic medicine was prone to have schools that did not teach the whole system
because it required a certain type of student to fully grasp the whole system. Outrage against the teaching of
“technics” can be seen almost from the very beginning of the profession. “What we need to teach is not technics, but
Ching 12

                                                                                                                                                                                                                                                                                                                                                                                                       
we need to teach treatment. And that means integrated treatment in which manipulative therapy is properly
coordinated with the total care of the patient, to fit total situations, rather than just “structural” problems out of the
context of the whole individual. As long as we have such courses in technic, the student doesn’t at the time see their
context, their relation to real-life problems.” The basic responsibilities of osteopathic education to society (panel
discussion). American Academy of Osteopathy Yearbook. 1957: 32.
38
Dr. Still recounts this story: “My father was a progressive farmer, and was always ready to lay aside an old plow
if he could replace it with one better constructed for its work. All through life, I have ever been ready to buy a better
plow.” Still AT. Autobiography of AT Still, revised edition. Kirksville, MO: Published by the author; 1908. p 225.
39
For an interesting look at the importance of institutional vs. individual thinking, please examine the following
article: Brooks D. What life asks of us. New York Times. January 26, 2009. Available at:
http://www.nytimes.com/2009/01/27/opinion/27brooks.html?emc=eta1
40
For a thought-provoking response to the current state of osteopathy, please examine: Jealous JS. Accepting the
death of osteopathy: a new beginning, Thomas L. Northrup Lecture, 1999. In: The Northrup book, Volume II, editor
HH King. Indianapolis, IN: American Academy of Osteopathy; 2009. p 80-2.
41
For an insightful look into American culture today and the rewards of manual labor, by a mechanic, literally,
please examine the following article: Crawford MB. The case for working with your hands. New York Times. May
24, 2009. Available at: http://www.nytimes.com/2009/05/24/magazine/24labor-
t.html?pagewanted=1&_r=1&th&emc=th Although the article is nominally about repairing motorcycles, the author
makes many cogent points that provoke comparisons to osteopathy and its functional roots as a manual profession.
42
Fryette HH. What does osteopathy mean to you? American Academy of Osteopathy Yearbook. 1947: 62.