L10-12: The Beginnings of Osteopathy-AT Still, Foundations & Osteopathic Medicine in 20th Century Flashcards
1
Q
What is homeopathy?
A
- Is a medical practice that upholds Samuel Hahnemanns principle of like curing like with drugs given in miniscule / single molecule amounts. Substances that cause symptoms of disease will likely cure sick people with similar symptoms.
1
Q
What is eclecticism?
A
- Is a medical practice that made use of botanical remedies along with other substances and physical therapy practices.
1
Q
Discuss the early spread of osteopathy?
A
- In the 1890s, word spread that osteopathy was effective. - It got favorable press in surrounding states, including Iowa. - There were huge increases in people arriving in Kirksville. - Celebrities and others gave public testimonials, including Roosevelt, Twain and the Rockefellers.
2
Q
What is phrenology?
A
- Involved character analysis by reading shapes/bumps on the head.
3
Q
Who are the sons of thunder?
A
- AT Still grew up in a strong Methodist family. His father was a circuit-rider and preacher for the Methodist church. These preachers were often called sons of thunder in that they preached hellfire and brimstone sermons.
4
Q
Explain the decades-long battle for full practice recognition in all states.
A
- Osteopathy was omitted from many state licensure laws in the early 20th century. The last state to fully license osteopathic physicians was MS in 1973. - The AOA formed from ASO grads in 1901 battled for recognition and licensure of osteopathic physicians in all states. - DOs were excluded from medical service during WWI, could only function as orderlies or common soldiers. - AMA created a standardization of hospitals policy in 1918 that required hospitals training MD graduates to exclude DO applicants from staff privileges lasting late into 20th century. This meant that no DO could practice in allopathic hospital, DO students could not train in allopathic programs, allopathic CE programs refused DOs and AMA listed osteopathic medicine as cult and made it unethical for MD physicians to associate with DOs. This lead to necessity for creation of osteopathic hospitals in the 1920s. - WWII saw DOs excluded from serving as physicians as in WWI. They remained at home and provided many Americans with their first experiences with osteopathic physicians. GI bill following war created boom in osteopathic education of veterans. - Federal support allowed for easier construction of osteopathic hospitals - CA debacle ensued in 60s. AMA removed osteopathy from list of cults. - Ethics change by AMA allowed MDs to work with DOs - AMA encouraged state associations to allow DO members and by 1969, allowed to join AMA. - Vietnam war really change everything for DOs. It was an unpopular war, military doctors were severely need as physician enlistments were low. MDs and DOs were drafted. Military medicine became proving ground for abilities and education of osteopathic physicians. - War promoted civilian acceptance of DOs into allopathic hospitals and joint practices. Eventually allowed for DO acceptance into military residency programs. - Late 20th century saw postgraduate training extending to DO graduates by all allopathic institutions, allowing for certification in specialty for DOs by osteopathic or allopathic routes.
4
Q
Who is Louisa Burns?
A
- She was a DO and the first full-time researcher into the osteopathic concept. She headed the west coast branch of the AT Still Research Institute.
5
Q
When does Still first use the term Osteopathy?
A
- In June 1874, he writes: “I flung to the breeze the banner of Osteopathy.”
6
Q
Explain the influence of Evolution on Still.
A
- First coined by Spencer, a British philosopher, who wrote a popular book on Darwin. Book popularizes ideas about cause and effect in disease, structure and function interrelationship and holistic workings of organisms. - Still embraces/discusses similar/same concepts in osteopathic principles.
7
Q
Who is Charles Hartupee?
A
- He is the first DO to settle permanently in Iowa and opened an office in DSM.
8
Q
Describe medical education and practice in the 19th century and its effects on the thought of AT Still?
A
- There were no licensing laws and no formal training required to practice medicine. - Early medical training for Still was from his father by precept during the 1840s. Father was not formally medically trained. - He helped his father with treatments at various missions setup, including on Indians. He exhumed Indian bodies to study anatomy. - Infectious diseases were common at the time, from which many died especially on the frontier where Still grew up and lived. - Heroic medicine was still central/key to medicine during the 19th century. - In 1861, Still enlisted as hospital steward (claiming to be a military surgeon) and practiced using standard medicines for the time. He said that his medical service disgusted him. - His disgust was not unique, many shared similar sentiments. - Late 1850s, he studied mechanical/anatomical relationships, tried manipulation and spoke against drugs. - His wife died in 1859 after childbirth and he lost his 3 children to spinal meningitis in 1864. Believed that their deaths were due to medical ignorance. He was convinced of uselessness of drugs and gave up medicine. - Many systems of drug-free medical practice were present during this time including: eclecticism, homeopathy, phrenology, bonesetting, mesmerism/magnetic healing and spiritualism. - Still sought better medical education. May have attended KC medical school, disgusted with curriculum. Explored drugless alternatives, including bonesetting. Returned to practice in late 1860s, started manipulation in early 1870s. Advocated drugless, magnetic healing. - He advertised himself as a magnetic healer, was not very successful. Became itinerant physician. - In 1883, advertised himself as a lightning bonesetter, treating people from town to town.
10
Q
Discuss the beginning of osteopathic medical education.
A
- Founded the American School of Osteopathy in 1892. First course was 4 months long, graduates received Diplomate of Osteopathy (DO) degree. - Graduates were not licensed anywhere, laws didn’t recognize the degree. MO medical association made it difficult by exorbitant fee to practice manipulation. Later, bill passed in 1897 allow osteopathic practice. - Initially, ASO only taught anatomy and osteopathy. No physiology or pharmacology were taught. By 1896, curriculum included history, chemistry, urinalysis, toxicology, pathology and symptomatology. - New faculty, several with advanced degrees, were hired to teach new subjects. This included William Smith (an MD, also the first DO) and the Littlejohn brothers. These newcomers brought regular science and medicine to ASO. - 13 new schools arose during the end of the 19th century, including the SS Still College of Osteopathy started by AT Stills nephew Summerfield Still.
11
Q
What is osteopathy vs osteopathic medicine?
A
- Osteopathy refers to the strict adherence and practice of osteopathic principles without drugs or adjunctive therapies, while osteopathic medicine combines the principles of osteopathy with all modalities of “regular medicine,” including pharmacology, drugs and surgery/OB.
12
Q
How did osteopathy become osteopathic medicine? How did academic standards change?
A
- Under guidance of William Smith and Littlejohn brothers who served as faculty members at ASO. - They wanted all medical science and surgery with the exception of material medica included in the ASO curriculum. - They discovered historical and scientific evidence for osteopathy while incorporating regular sciences into ASO - Littlejohns later founded the American College of Osteopathy and Surgery in Chicago, becoming leaders for broadening of osteopathic principle. - In Des Moines, SL Taylor, MD from NE, surgeon at Hopkins under Halsted, became president of Still College. He was leader in calling for broad osteopathy. - Journal of American Osteopathic Assn started in 1901 contained mostly anecdotal case histories with rare failures of manipulative therapy. Basic research started and AT Still Research Institue est in 1913, with west coast branch headed by Louisa Burns. She was the first full-time researcher into the osteopathic concept. - AOA followed their lead, mandating longer curricula (3 years), plus broader education and practice in 1904. Many schools closed or merged. - AOA mandated 4 year curriculum in 1916, excluding medica. - 1940 saw instituting of two years of college pre-admission, three years by 1950s. Majority of entering class had baccalaureate degrees by 1960. - Expansion of colleges in 1970s.
13
Q
Explain the impact of the Vietnam era for osteopathic medicine.
A
- Vietnam war really change everything for DOs. It was an unpopular war, military doctors were severely need as physician enlistments were low. MDs and DOs were drafted. Military medicine became proving ground for abilities and education of osteopathic physicians. - War promoted civilian acceptance of DOs into allopathic hospitals and joint practices. Eventually allowed for DO acceptance into military residency programs. - Late 20th century saw postgraduate training extending to DO graduates by all allopathic institutions, allowing for certification in specialty for DOs by osteopathic or allopathic routes.
