A CENTURY OLD & COUNTING

It has been said that osteopathic medicine was ahead of its time. When it came into being a little more than 125 years ago, its natural and holistic approach to healing was unheard of. So was the concept of preventing disease before it occurs. In fact, those basic osteopathic principles were often ridiculed, and even considered by some to be pure quackery.

Today, however, the same views are right in sync with the American trend of combining traditional medicine with natural remedies. And much of what osteopathic medicine always espoused has now been integrated into allopathic medicine.

So exactly what is osteopathic medicine? It is a system of health care with a philosophy that the body is an integrated whole and that health is influenced by physical, psycho-social and environmental factors. Therefore, when diagnosing and treating patients, an osteopathic physician looks at the whole body, not individual systems alone. If a patient complains of stomach pain, for example, the doctor will look beyond the gut itself for possible causes.

The concept of "wellness" is also a part of the philosophy. In addition to treating illness, the doctor of osteopathy, or DO, acts as a teacher to help patients take more responsibility for their own well-being, as well as to change unhealthy patterns.

One contribution of osteopathic medicine is osteopathic manipulative therapy or OMT. This is the manual manipulation of the musculoskeletal system which is very effective in treating musculoskeletal problems such as back pain. Many do not realize that the founder of chiropractic studied at the founding school of osteopathic medicine before leaving to establish the first chiropratic school.

The use of OMT is one of the principal differences between osteopathic and allopathic medicine. MDs and DOs use the same basic curricula in medical school and take the same licensing exams. Osteopathic physicians serve as faculty members in allopathic medical schools and vice versa, and hospital rosters and individual practices are now mixed.

Many top-notch students with their pick of medical schools are deciding to become osteopathic physicians. Students at UMDNJ-School of Osteopathic Medicine (SOM) have graduated from state colleges, like Towson State in Maryland, Penn State and the SUNY system, and others are graduates of private schools like the University of Pennsylvania, Duke and Notre Dame. First-year student Laura Nelson, a graduate of Clemson, says when she learned about osteopathic medicine in college, she immediately knew that was what she wanted to do. "It's who I am," she says. "I was accepted at an allopathic medical school, so I had a choice. But going there would have gone against my personal beliefs," she says. "Medication certainly has its place in treating patients, but I believe there are natural methods, like OMT, that are equally as valuable." Nelson adds that she also "loves" the philosophy of treating the patient as a whole, with body, mind and spirit working as one.

Chirayu Parikh, another first-year student, comes from a family of physicians: two uncles and two cousins are allopathic physicians, and two other cousins are currently enrolled at osteopathic schools. The Boston College graduate was accepted at both types of schools as well. When it came time to choose he looked at the school itself, he says, not the type of medicine. "How good a physician I become is up to me," Parikh says. For me, SOM was the best fit. The atmosphere is very supportive and the faculty and facilities are among the best. And the extra training I'm getting in OMT will give me another way to help my patients. That was a definite draw."

These students' stories would no doubt thrill the earliest proponents of osteopathic medicine. They were greatly outnumbered by their allopathic counterparts and fought long and hard for acceptance, even into the 20th century. By the early 1970s, however, all the barriers between the two types of medicine were gone. Medical history began in America with the early settlers who healed themselves with botanical preparations. In some areas, these treatments were combined with remedies learned from the Native American healers. This very basic form of health care was overseen by physicians, but most were ill-equipped to treat patients. The few American medical schools that did exist in the 1800s were far inferior to those in Europe. Entrance requirements varied widely, as did the length of study and the curricula. A three-year apprenticeship was another way of becoming a doctor, and some men did both. In either case, health care was inadequate at best.

There were three distinct groups of physicians at the time. The regular physicians, as they were known, or allopaths, were the largest. They used any combination of three harrowing treatments that would be considered barbaric by today's standards: blood-letting, purging and blistering. To bleed a patient a physician would cut a vein length-wise with a scalpel. Purging was accomplished by administering a chalky mercury preparation known as calomel, which would cause acute salivation, violent vomiting and diarrhea. Blistering was done using a variety of methods — from touching the skin with heated metal to applying irritating plasters — and was performed on the area of the body believed to be opposite the site of the illness. Physicians believed these therapies drew the illness out of the body, along with the fluids that were released.

It wasn't surprising that these torturous treatments were challenged. One young physician, Andrew Taylor Still, took a step back from the way things were being done in medicine, after watching helplessly as three of his children died of meningitis. He was sure there was a better way.

The son of a medical missionary, Still was traditionally trained for a physician of his day. The young doctor also read medical books and learned anatomy by dissecting bodies from a nearby Indian burial ground. Like most frontier doctors, Still did other things besides practice medicine: he was a farmer and a mechanical worker. During the Civil War he served as a physician in the Union Army. He first articulated the idea of improving health care while living in Kansas in 1874. He philosophized that the body has much in common with a machine, and should function properly if it is sound. Like all the components of a well-oiled machine, Still believed the body's parts work in unity, thus he advocated using a holistic approach to medicine. He also believed in the ability of the body to heal itself if the musculoskeletal system was functioning properly. And he was the first to study the attributes of good health so he could understand the disease process. That led him to the theory that illness could be prevented by living healthfully.

Still needed a name for his new system of care. Since he was using primarily the skeletal system to do manipulation, he felt the Greek root "os" (osteon, or bone) was aptly descriptive. As other forms of healing use "pathy," for example allopathy and homeopathy, (pathos is Greek for suffering) he entitled his system osteopathy. He continued to use some drugs at first, but gradually he came to condemn nearly all medications of his day because he felt they lacked a research base. His reputation was mixed at first, but eventually testimonials to the efficacy of his care began to spread. In 1892, he opened the American School of Osteopathy, and in 1894, the first DOs graduated: 18 in all.

By the 1930s, the osteopathic philosophy had been expanded to include medicines proven to be valuable through research. Today there are 19 osteopathic medical schools across the country. While primary care is still at the heart of osteopathic medicine, it also embraces research and the specialties that have become so important in the changing face of today's healthcare.

Osteopathic medicine has been practiced in New Jersey for an entire century. In celebration of this event, a book, Osteopathic Medicine: A Reformation in Progress, was edited by Frederick J. Humphrey, II, DO, dean of SOM, and R. Michael Gallagher, DO, vice-dean of the school who also authored the chapter on the future. The book was recently unveiled at an American Osteopathic Association (AOA) Convention in Florida. Humphrey says the book is for osteopathic physicians and students, but it is also designed for legislators and other public figures interested in learning about osteopathic medicine. Donald J. Krpan, DO, president of the AOA, says, "This book lays the groundwork for the future of osteopathic medicine by reminding us of our past."

The historical information in this article was taken from the book.