In the last year of the past century, Dr. Andrew Taylor Still, the founder of the osteopathic profession, succumbed to the demands of his students and wrote a book, Philosophy of Osteopathy. He wrote it reluctantly, not convinced that the time had come for the general principles he taught and practiced to be perpetuated as rules. "Osteopathy is only in its infancy," he wrote. It is a great unknown sea just discovered, and as yet we are only acquainted with its shore tide."
Despite his reluctance, the book was published. Fortunately, his fears were not realized. The principles he described never became dogma for osteopathic physicians. They helped explain, instead, to physician and patient alike, the reasons why osteopathic skills are applied and why osteopathic care is beneficial. They turned the eyes of the physician and patient away from the narrow, specialized view of the human body, which seemed to overwhelm medical thinking in the early years of this century, and caused them to remember that man, in both sickness and health, is a complex, complete, indivisible organism.
Most importantly, the principles became the firm foundation on which succeeding generations of osteopathic physicians, surgeons, and researchers could build. Through scientific experimentation and countless hours of patient care, they were able to test, validate and at times modify the principles on which osteopathic care is built. They learned that the principles set forth by Dr. Still not only are applicable to human health and disease, but provide osteopathic physicians and surgeons with a comprehensive view of the human body– a philosophy of medicine that can show a physician not only what he can and cannot do, but also what he ought and ought not do. Finally, they continue to remind osteopathic physicians that the practice of medicine (should) remain as important in medical practice as the science.
In diagnosing and treating their patients, osteopathic physicians are guided by certain generally accepted principles concerning the normal workings of the human body.
Abnormal structure or function in one part of the body exerts unfavorable influences on the other parts and, therefore, on the body as a whole.
The holistic view, generally attributed to Hippocrates, the "father of medicine", recognizes that the body is not just a network of independent compartments. It is not simply a human machine comprised of the heart, the lungs, the intestines, etc. It is, instead, a complexly interrelated community of organs and systems, each dependent on the other, each contributing to the other, each compensating with the other to meet the constant demands of internal and external stress.
Despite our common tendency to isolate illness within a certain area of the body, osteopathic physicians recognize that when the body is sick, it is sick all over. A specific organ may become the central focus of illness, but the effects of the illness are felt in varying degrees throughout the body.
Likewise, when responding to illness, the target organ does not work alone. The entire body, through the circulatory, nervous, and endocrine systems, is mobilized, as armies are mobilized for battle, in a cooperative effort to combat the effects of body illness. Only when the war has ended, when the whole body has returned to its normal balance, has the victory over the Particular illness been truly achieved.
Osteopathic physicians, through their knowledge of physiology, recognize that health and illness are not separate, distinct, and diametrically opposed conditions. The body, rather than resting in a state of health or illness, is constantly fluctuating between the two, It is engaged in a never ending struggle to adapt itself to the ever changing demand of its internal and external environment. It seeks, through constant change, to resist, neutralize and overcome the continual stresses, physical and psychic, to which it is subjected.
The body's ability to fluctuate and adapt to stress determines the degree and state of its own health. If it can meet the various forms of stress adequately and without exaggeration, it will remain healthy. But when some disorder within the body disrupts its adaptability, or when some force in the external environment Overwhelms the checks and balances of the internal equilibrium, disease and illness take the upper hand. Illness, despite the constant stresses to which the body is subjected, is, for most persons, only an occasional experience. It must follow, therefore, that in the vast majority of Instances that the body is able to resist disease and overcome illness without being consciously aware of the drama that is taking place.
In order to live, all body organs and systems need a constant supply of fresh blood. In order to function normally, they must be constantly controlled by nerve impulses.
Blood, transported via the circulatory system, brings food and oxygen to all the cells in the body and removes waste products from the blood. Blood, however, is more than just a vehicle of transportation. In its journey through the body, blood connects and integrates the function of one part of the body with the others– the lungs with the intestines with the liver with the muscles, etc.– so that the entire body can function and respond as a whole. Likewise, nerve impulses transmitted to and from the brain and spinal cord, not only excite or inhibit the actions of individual organs and tissues but cause them, in effect, to lose their individuality and become interacting and interdependent parts of a cooperative enterprise.
Remembering the first principle of body unity, it becomes clear that any disturbance in the circulatory or nervous systems must, in some degree, affect the function of the body as a whole.
In summary, the human body is an integrated organism with the inherent capacity to resist disease and heal itself. Health and illness are conditions of the whole organism. Abnormal structure or function in one part of the body exerts abnormal influences on other parts and on the body as a whole. The nervous and circulatory systems, finally, not only integrate the normal functions of the body but, if disturbed, inhibit the body's natural restorative and reparative powers.
The fundamental contribution of the osteopathic profession, based on the above principles, is the recognition that the body's musculoskeletal system (bones, joints, connective tissues, skeletal muscles and tendons) play an important role in the body's continuous effort to resist and overcome illness and disease. Osteopathic physicians have repeatedly demonstrated that this largest of the body systems both reflects internal illness and may actually aggravate or accelerate the process of disease. Based on this recognition, the osteopathic profession has developed a unique system of diagnosis and treatment that, when employed in conjunction with other standard medical procedures, may be highly beneficial in the treatment and prevention of disease.
The osteopathic profession was born in a spirit of medical reform and continues to strive for even greater reform. It seeks, through continued study and the application of its holistic philosophy, to offer complete medical care– medical care that gives full recognition to the role played by the musculoskeletal system in health and disease. It seeks to demonstrate the importance of the musculoskeletal system in the diagnosis of the disease and the value of manipulative procedures in the treatment of disease and the maintenance of health. The distinction is of such major importance to the health and welfare of all people that it motivates and maintains a separate profession of steadily growing numbers and influence.
Reprinted from "Briefs", Spring, 1985, Volume 85-1.
