Introduction
Efforts to define osteopathy have been made for a long time but failed. Researchers concluded that osteopathy can’t be defined. On the other hand, they showed that it can only be described. Osteopathy can be described as a measure taken to facilitate or assist the body’s ability of self-healing; in so doing the practice promotes/enhances a person’s medical wellbeing.
Osteopathic medicine which has become part and parcel of the United State’s medical practice has had spillover effects in over 47 other countries around the world. Osteopathic medicine is the brainchild of Andrew Taylor Still. Andrew Still’s modus operandi relied heavily on the manipulation of joints and bones to detect and treat illnesses (Galewitz, 34). Andrew Still called this practice ‘osteopathy’.
Since its inception, Galewitz says that there has been enmity between the Doctors of Medicine (MDs) and the Doctors of Osteopathic Medicine (DOs). However, this hostility has become abated with the later practice adopting contemporary medical practices. As shown by Galewitz, osteopathic practitioners were turned into osteopathic physicians, slowly getting all needed rights as medical doctors, this included serving in the army as physicians (Galewitz, 34).
Galewitz further states that “In addition to the Hippocratic oath, Osteopathic medical students take an oath to maintain and uphold the “core principles” of osteopathic medical philosophy”. These core principles are of great importance since they define the way an osteopath physician approaches a particular sickness (Kamau, 12). The approach visualizes a patient’s body as a composition of body, mind, and spirit. This has made people view osteopathic medicine in a perspective analogous to holistic medicine.
Therefore, this paper is going to focus on the history of osteopathic medicine, the core principles of osteopathic medicine, the importance, and the extent of practice together with critics of this practice. The paper will finally conclude by giving an insight into current practices in osteopathy.
The history of osteopathic medicine
The history of osteopathic medicine dates back to the late 18th century in the United States of America. A scientist by the name of Andrew Taylor Still who is a pioneer and the founder of this practice opted to go against contemporary medical practices to come up with this. Galewitz (34) states that Taylor Still founded a School of Osteopathy in America in the early 90s as a drastic protest against the other medical systems.
Still had a strong belief that the other medical system was deficient incredible efficacy (Gelewitz, 34). He believed that it was ethical and had remedy on effects rather than causes of ailments. That’s when he founded this medicinal practice. This was in an era where medications, surgical operations, and other traditional treatments often brought more harm than good. “Some of the medicines commonly given to patients during this time were arsenic, castor oil, whiskey, and opium. In addition unsanitary surgical practices resulted in more deaths than cures” (Gelewitz, 34).
According to Brooke, Taylor envisioned his way of thinking as a renaissance in the medicine world. He emphasized the minimal use of drugs with much emphasis skewed towards surgery and musculoskeletal systems. Brooke further states that “he invented the name “osteopathy” by blending two Greek roots osteon- for bone and -pathos for suffering to communicate his theory that disease and physiologic dysfunction were etiologically grounded in a disordered musculoskeletal system” (Brooke, 16). Taylor carried out this practice, by making a diagnosis and taking care of the musculoskeletal system. He supposed that medical practitioners could treat many ailments with no negative side effects of medicine (Andersons, 148)
As Brook puts it, this kind of practice which by definition is simply the treatment of diseases by the manipulation of bones and joints was seen as a cultic practice that was criticized by medics allied to the American Medical Association. The American Medical Association branded this practice a sham and illegitimate as it was going against its code of practices. In contrary to the American Medical Association claims, there was cited evidence of a cure from the public domain.
One such evidence Brooke states was Mark Twain’s revelations. He stated that “manipulative treatments had purportedly alleviated the symptoms of his daughter Jean’s epilepsy as well as Twain’s chronic bronchitis” (Brooke, 25). In 1910, he said before the state assembly that at first, he did not care about the osteopathic practice until he heard that it could be abolished.
Mark Twain was responding to the allegations which were against osteopathic treatment at the height of the tension between conventional medicine practices and osteopathic medicine. As days went by, osteopathic medicine became more familiar and accepted but it was not until 1966 after a tug-of-war between the two factions that it became acknowledged. In 1966 a secretary of defense approved the recognition of dos in medical military services. It was again done on the same criteria as MDs (Galewitz, 35).
To-date, osteopathy has had an enormous acknowledgment around the world. It has been adopted in virtually the entire states in the United States and a majority of Canadian states. According to Fauci, osteopathic practitioners in the U.S became osteopathic physicians. They slowly achieved all rights as medical practitioners and doctors in the U.S. This again included serving in the American army as physicians (Fauci, 201).
The core principles of osteopathic medicine
Osteopathic medicine operates under the set ‘core principles’ which were established in 1953 and later on revised in the year 2002 (Mullan, 13). “Osteopathy is not only a neuromusculoskeletal-oriented diagnostic and treatment system; it is also a comprehensive and scientifically based school of medicine that embraces physiology” (Still, 5). “These principals are put in the following ways; the body is a unit, and the person represents a combination of body, mind, and spirit. The body is capable of self-regulation, self-healing, and health maintenance. Structure and function are reciprocally interrelated” (Mullan, 14). Rational cure is again founded on the knowledge of these doctrines; “body unity, self-regulation, and the interrelationship of structure and function”. (Mullan, 14)
Under this context of looking at a person as a unit, it encompasses the body, mind, and spirit. Still, further explains that there is a great relationship between the discrete body parts to maintain the supreme functioning of the body. According to Still, the body fluids and the nerve center are the communication pathways vital in the relaying of information. Still states that “the circulatory and nerve system also mediate the regulation and the coordination of cellular, tissues, and organ function and thus the maintenance of the integrity of the body as a whole”(Still, 13). As shown by still again, the malfunction of one system eventuates to the failure of the entire body system.
Still points out that when you are not feeling well, it is not the body and the mind but it’s your soul. He says, “it’s you, who feel well, ill, happy or sad, and not your body or mind”. Whatever transpires in your body is programmed by your spirit, your whole genetic background, and your ecosystem history. Still asserts that a person with a peptic ulcer is not ill as a reason for the ulcer. The ulcer subsists as a result of the adverse internal conditions (Still, 14). In a nutshell, the body’s functioning is depended on the state of the individual components that constitute the entire body, the state of mind, and the spirit.
According to Mullan, the second principle states that “the body is capable of self-regulation, self-healing, and health maintenance” (Mullan, 14). Mullan brings forth the term ‘homeostasis’ which he defines as “the property of a system, either open or closed, that regulates its internal environment and tends to maintain a stable, constant condition” (Mullan, 23). According to Mullan, a creature can either be a conformer or a monitor of the external condition.
A creature strives at maintaining an internal condition that is favorable for its optimal functioning by the virtue of homeostasis. According to him, conformers develop adaptive features which help them in the regulation of an internal environment to behave normally. Homeostasis gives the body-wide scopes of flexibility to enable it to adjust to different conditions. Mullan further states that the regulation of homeostatic is managed by the discharge of hormones to the bloodstream.
However, other management/regulatory procedures rely on uncomplicated diffusion to uphold balance (Mullan, 15). An illness is normally attributed to homeostatic disproportion. “Many diseases are brought about by the disturbance of homeostasis; this is a state called homeostatic imbalance. As it grows older, all organisms lose effectiveness in the control system (Brook, 12). In a synopsis, the body has its natural regulator to enable it comfortably live over a wide range of conditions for survival.
As Mullan puts it, there is a need to harmonize the different entities lest the body succumbs to illness. Paulo on the other hand states that; “proponents of visceral osteopathy show that, the visceral systems (the internal organs: digestive tract, respiratory system, etc.) rely on the interconnection synchronicity between the motion of all organs, structures of the body, and that at optimal health” (Pattulo, 12). This synchronized connection remains intact despite the body’s continual varieties in motion.
As stated by Pattulo, there is an interrelation between the different functioning of organs making up the body to perform a common task. The organs activities are interdependent failure of which sickness occurs. There is a need to understand these principles in three dimensions for one to appreciate the osteopathic treatment. “Rational treatment is based on an understanding of these principles too, which are body unity, self-regulation, and the interrelationship of structure and function”. (Kurt, 14)
The importance of osteopathic medicine
The osteopathic medicine approach to medical issues is viewed in a different perspective relative to conventional medicine. Retz states that the philosophy of osteopathic practice is akin to the doctrines of holistic medical practice. “They suggest that osteopathic philosophy is a kind of social movement within the field of medicine, one that promotes a more patient-centered, holistic approach to medicine, and emphasizes the role of the primary care physician within the health care system” (Retz, 34).
Retz puts much weight on primary care which he defines as the job of medical care experts who act as consultants for all patients (Retz, 35). Retz further says that osteopathic practitioners are at all patients’ disposal when in need of advice regarding their health. These practitioners are known as primary or secondary care physicians (Retz, 35). The good thing about this is that they need no pre-invitation letter to access their services.
Primary care services offer extensive health care services; “including all ages of patients, patients of all socioeconomic and geographic origins, patients seeking to maintain optimal health, and patients with all manner of acute and chronic physical, mental and social health issues” (Longo,142). Primary care aims at enhancing a stable health condition after treatment and release of a patient so that in case of an anomaly the remedy is instant. Longo explains that stability is a key desirable aspect of primary care, as people with diseases normally prefer consultancy as well as primary care during routine check-ups,(Longo, 146).
Paulo on the other hand visualizes a holistic approach as a compound term. Paulo defines it as “a concept in medical practice upholding all aspects of people’s needs (psychological, physical and social, and mental), which should be taken into account and seen as a whole” (Pattulo, 23). Under a holistic approach the consequence of illness is due to the disparity in these constituents that sums up a body.
The extent of osteopathic medicine
Since the inauguration of osteopathic medicine in the 1960s after hustle and tussle with medical doctor counterparts, the rivalry between the two factions was minimized. Osteopathic practitioners campaigned for its appreciation and on 3rd May 1966, they got the central government backing (Mathews 43). Another author Croasdale states that the earliest DO to start practicing osteopathy in the military was Harry J. Walter. He further says that “the acceptance of osteopathic physicians was solidified in 1996 when Ronald Blanck, DO was appointed to serve as surgeon general of the army, the first osteopathic physician to hold the post” (Croasdale, 200).
Since then statistics have shown a growing number of graduates from osteopathic medical colleges. According to Jameson, from the early 80s to mid-2000, osteopathic graduates had increased by over 250%. This number is supposed to double by 2015 (Jameson, 45). Jameson continues by saying that, osteopathic medics have a training system that is likened to allopathic medics. “Generally, the first two years are classroom-based, while the third and fourth years consist of clinical rotations through the major specialties of medicine” (Jameson, 48).
It has been noted that osteopathy has changed so much and can be categorized into two separate groups. “The osteopathic profession has evolved into two branches, practitioners in the United States and Canada, and practitioners in European and Commonwealth countries. These groups have grown so distinct that in practice they function as separate professions” (Hauser, 23). In many European states and commonwealth countries, their mode of operation is exclusive of surgical and pharmaceutical approaches. Hauser explains that osteopathy in these countries is seen as institutions of manual medical care, this is opposite to many mainstream medicinal practices (Hauser, 24). As much as this practice is carried out in these regions, osteopathy has also grown immensely in other continents around the universe.
In Australia by the year 2007, they were celebrating the first anniversary since its inception and its level of growth is analogous to that in Britain. It was until 1970 that Australia officially started educating on osteopathy. Before 1970, the training was unofficial. “From early 70s Australia has educated practitioners even though most were educated less formally before that time (Galewitz, 44). In Australia and New Zealand again governments only recognize practitioners who are registered or otherwise are deemed, illegitimate osteopaths. “Both Australia and New Zealand practitioners require registration. This disallows osteopathic practice except by government registered practitioners” (Galewitz, 45).
In other places like Israel for example, osteopathy is just on the verge of recognition as there is a bill put in place that is fighting for its legitimacy. As shown by Jordan Cohan, “in Israel a joint Osteopathy and Chiropractic Bill are in the process of going through the Knesset (Israeli Parliament). The bill will in effect and define osteopathy as an academically based profession” (Cohan, 45). On the other hand, United States osteopaths are deemed legal to work in Israel unconditionally. “USA trained D.O.’s (“Doctor of Osteopathic Medicine” degree holders) can again eligibly apply for and receive unrestricted license to practice medicine in Israel” (Cohan, 45).
Critics of osteopathic medicine
The practice of osteopathic treatment has drawn a lot of controversies in the world over. This has been done with the advocates of these practices lobbying for campaigns for their recognition. According to Brook, there was so much animosity in the United States between the two facets i.e. allopathic and osteopathy that culminated in triumph and hence official recognition of the later. “In the 1960s in California, the American Medical Association (AMA), sensing increased competition from osteopathic medicine, spent nearly $8 million to end the practice of osteopathic medicine in the state” (Brook, 25).
As much as the osteopaths continue carrying out their practices, there have been a lot of criticisms. One such practice that has sparked condemnation is Osteopathic Manipulative Treatment (OMM). Osteopathic manipulative treatment has been criticized for its many techniques. These include cranial and cranio-sacral manipulation. Recent research shows critics questioning the beneficial utility of these modalities (Bluff, 25). According to Bluff, this treatment cannot operate independently since it requires the support of conventional medicine. As a result, they believe one cannot bank on it for a remedy. However, there are some ailments for which the benefit of manipulative treatment has reputable medical support (Bluff, 25).
Another raging criticism is the fact that Osteopathic Medicine practice is shallow in research and scientific inquest relative to their medicine counterparts. In Brooks point of view “the inability to institutionalize research, particularly clinical research, at osteopathic institutions has, over the years, weakened the acculturation, socialization, and distinctive beliefs and practices of osteopathic students and graduates” (Shannons, 75).
It has been reported by Fisher that the osteopaths lack uniqueness since there is no defined line drawn between them and allopathic medicine. Fisher states that; if this practice has become a useful correspondent of allopathic-practice, then it’s the validation for its own continued presence. Again he says that there is worthiness in treatment that is exclusively osteopathic; its use should again not be limited to osteopaths (Fisher, 135).
Conclusion
Osteopathic medicine is vital in medical care and cannot be sidelined in favors for allopathic medicine. Osteopathic approach to diagnostic medicine is a big plus to its practice since it gives moral support to its patients. As much as there have been strong criticisms to this kind of practice, it has been reported to provide remedy to many diseases. However, there is need for moderation since it lends support from allopathic medicine and over reliance of this therapy alone is unhealthy. Therefore as shown in this paper, governments should fund the research on osteopathy to come up with more justifiable beneficial practices.
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