Lecture 1: History

Question 1

AT Still

Answer 1

• Founder of osteopathy 1828-1917
• Born in Jonesville Lee County VA
• Father was a doctor, circuit rider & physician
• AT accompanied him & watched him minister to the sick.
• Moved from Va to Tennesee

Question 2

Early Life of AT Still

Answer 2

• Father got sent from TN to Missouri
• Lived in a log cabin & hunted which required comparative anatomy
• At age 10, he realized a headache can go away by suspending the action of the greater occipital nerve to give harmony to the blood & veins

Question 3

What was AT Still’s father’s view on slavery?

Answer 3

Father did not believe that “human slavery was of Divine origin”, and preached that slavery was a sin.
Father was transferred from MO to be a missionary to the Shawnee Indians in Kansas, at the Wakarusa Mission.
Kansas was a free state.

Question 4

What was the Shawnee influence over AT still?

Answer 4

Dr. Still had difficulty with preacher’s proclamation that, “All of God’s work are perfect”, and the use of toxic drugs. Believed we didn’t need poisons to recover.

Shawnee believed in supreme being that permeated all of nature, material & spirituality were inseparable –> resonated with Still

Question 5

Explain Dr. Still’s influence of the civil war

Answer 5

• He moved to Kansas to work as a military surgeon & a major in the calvary
• Was exposed to European Bone setting from the mercenaries.
• Reduced dislocations, passed down manipulative skills, & provided relief for the poor who couldnt afford doctors

Question 6

What year was the AMA founded?

Answer 6

1847, prior to this medicine was not scientific. No licensing boards, no entrance exams, no curriculum. Only training through apprenticeship

Question 7

Heroic Medicine

Answer 7

Advocated by Ben Rush

• Purging
• Blood letting & use of leeches
• Blistering
• High doses of mercury, opium, alcohol

Examples; Merck’s Manual 1899:
-Mercury Cyanide was used as a gargle.
-Chloroform mixed with opium for coughs.
-Hiccoughs were treated with cocaine,
cannabis, sugar and vinegar, and smoking tobacco.
-Cracked lips- lead nitrate
-Dandruff- mercury, aluminum, lead acetate
-Acne- arsenic, sand paper
Sinusitis- arsenic as a cigarette or internally

Question 8

Thompsonian Medicine (Ecclecticism)

Answer 8

Samuel Thompson - self-taught herbalist from NH
A New Guide to Health
Herbal healing
Rejected heroic measures
Used botanicals to open pathways of elimination
Helped inspire naturopathy

Question 9

Who founded homeopathy?

Answer 9

• Christian Friedrich Samuel Hahnemann, MD (1755-1843)
• 1796 coined term “homeopathic medicine” with its Law of Similars
• Appealed to nonheroic physicians
• In America, eventually merged into allopathic system
• Hahnemann medical school

Question 10

When was the “Flag of Osteopathy” flung into breeze?

Answer 10

June 22nd 1874

• AT spends 10 years studying anatomy & physio
• Friend John Abbott influenced
• Summer of 1874, Still became known as a heretic for promoting the idea of osteopathy & criticizng the usage of toxic medications

Question 11

What happened with Still at Baker University in Baldwin, KS?

Answer 11

• Refused to let him teach, said he was trying to imitate Christ by laying hands to perform miracles
• Moved to Kirksville & started to practice as a bone setter.
• Made a circuit in towns and his popularity surged as a healer, hundreds of pt’s waiting to see him

Question 12

What does osteopathy translate to?

Answer 12

Osteo (bone) pathy (incoming effects from bone)

Idea was that the bone structure had to be good in order for the fascia on top to function properly

Question 13

When was the American School of Osteopathy (ASO) founded?

Answer 13

1892. 1st Class:
      - 15 men & 3 women
      - Ages 18 to 65
      - Anatomy was core of teaching
      - Dr. William Smith taught anatomy while learning osteopathy with Still

Question 14

What was the usual treatment protocol at the ASO?

Answer 14

Stayed one month in Kirksville
Contract to abstain from all alcohol & drugs
OMT 3 times/week
Usual complaints: chronic, noninfectious diseases

Question 15

Which state was the first to grand licensing to DO’s?

Answer 15

1896 Vermont first state to grant license to osteopaths
1897 – Missouri passed legislation guaranteeing D.O.s right to practice in that state

By 1901 – 14 states licensed osteopathy

Question 16

Lesion Osteopaths vs Broad Osteopaths

Answer 16

Was the divide between DO’s.

Lesion: wanted to adhere to Still’s teachings, trying to keep surgery, OB & pharm out of curriculum

Broad: wanted to add surgery and OB & pharm

Question 17

What did the Flexner report result in?

Answer 17

1910-Flexner report
Abraham Flexner was commissioned by the Carnegie Institute to evaluate all of the medical schools in US and Canada (155), using Johns Hopkins as the gold standard
-8 osteopathic schools
-Poor quality medical schools forced to close
-Only 65 MD institutions survived, 5 osteopathic schools improved curriculum, rest closed.

Question 18

How did osteopathy affect the Spanish Flu?

Answer 18

Lowered mortality and pneumonia mortality
from 5-6% to .25% for influenza

and from 30% to 10% for pneumonia.

-Technique was to manipulate the lymphatics & increase drainage via thoracic pump to decrease the work of breathing

Question 19

Describe the decline of OMT

Answer 19

In 1930s, as pharmacology became more prevalent many surgeons & doctors resorted to writing prescriptions than using OMT.

AAO founded in 1937

Question 20

How did WWII give osteopathy a boost?

Answer 20

DO’s were ineligible to practice in the war. Stayed back with women & kids, women stuck with their DO provider even after war ended.

1950- Audrain County, MO- court decision establishes right of DOs to practice in public hospitals as complete physicians and surgeons
1956 – DO profession recognized by U.S. Public Health Service for renewable teaching grants
GI Bill could now fund osteopathic medical education
Late 1950’s- term “osteopathic medicine” replaces “osteopathy”

Question 21

What did the committee that visited the DO schools find?

Answer 21

That the curriculum was basically the same, along with the length of study.
-Stated that it could not be called cult healing with a merger in the future possible

Question 22

1961 California

Answer 22

First state that the AMA delegated was okay for unification. Cali osteopathic association & medical association.

-Didnt work out, not enough DO residencies. No referrals from MDs. DOs took class to become MD’s, discounted licensure for DO. DO school converted to MD school (UC School of Med at Irvine)

Question 23

Difference between DO & Chiro?

Answer 23

DO’s believed dysfunctions were not “bones out of place” but reflected neuromuscular dysfunctions
-Used gentle techniques and not back thrusting to put bone back to place

Question 24

Which of the following events in osteopathic history was followed by a significant strengthening of the AOA and the opening of several new COMs?

Answer 24

The California amalgamation/merger

Question 25

First state to license DO’s were:

Answer 25

Vermont