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CHAPTER IV

THE MANIPULATIVE CULTS: OSTEOPATHY

    ABOUT twenty-five years ago, in a small select boarding-house in Chattanooga, Tennessee, I established my first personal contact with Osteopathy. It came about through a young couple stopping in the same hostelry, and who—as I was informed by our landlady—"practised osteopathy in a down-town office." They were quiet, pleasant-mannered, well-dressed and apparently well-bred people, carrying none of the bizarre, outre effects of personal appearance by which the author of the "Fishbein Follies" has sought to distinguish the Cultists.

    The South was then, as now, the most conservative section of the Union, subscribing to orthodox standards in medicine and religion and paying little attention to innovations in either. This pair of osteopaths, who had come from a Northwestern State to the Tennessee town, were not, as I recall, subjected to any form of persecution or social ostracism, however, because of their strange therapeutic gods. But the rest of the boarding-house clientele —including myself—being firmly entrenched in medical tradition, manifested no interest in the newcomers and their new healing cult, until one day something happened to draw my attention to it.

    Among the boarders was a little woman friend of mine, the mother of two small boys. The elder, a frail little lad of eight, suffered from periodic attacks of severe headache which kept him from school at times. One evening after supper, when the boy had been absent from the dining room because of one of his headaches, the osteopath approached the mother, who stood chatting with me at the foot of the stairs, and said: "Pardon me, but I couldn't avoid overhearing you tell your friend at supper that you were in the habit of giving your little boy calomel for his headaches, is it so?"

    "Yes," the mother replied. "Our family physician at home thought Billie's headaches caused by a torpid liver and bad circulation, and he prescribed the calomel, because he said there is nothing like calomel for giving the liver a good shake-up."

    "Well, he hadn't heard about Osteopathy," returned the osteopath, smiling. He was a tall dark man, rather handsome, and when he smiled showed a particularly good set of teeth. "Now I don't wish to be intrusive," he went on, "but I hate to see the little fellow suffer, and I know it is a crime to give him calomel. If you will let me try to see what our osteopathic treatment will do toward correcting his trouble, it shall cost you nothing, and you can come along—and bring your friend also—to see that we don't do anything very terrible to him," he added, with a laugh.

    This was unheard of in the allopathic code—a doctor tendering his services unsought! My friend stiffened a bit at the osteopath's first words, but as he proceeded, his frank manner and manifestly sincere desire to be kind, disarmed her suspicions, and after a moment's hesitation she consented to bring the boy to Dr. E———'s office the following afternoon. And I, whose curiosity was considerably stimulated by what I had heard, agreed also to come with them.

    We arrived at the osteopath's office at the appointed hour, and were greeted by both Dr. E——— and Mrs. E———, who was also an osteopathic practitioner. I watched the osteopathic manipulations with keen interest and even before he had finished I was well-nigh convinced that here was a pretty good technique for stirring a sluggish circulation. The boy's heightened color and sparkling eyes when the treatment had ended, converted this impression into a certainty. The treatments were continued every day for two or three weeks, and then on alternate days for another period of weeks. At the end of two months, according to the mother's testimony, the boy's old "sick headaches" had completely disappeared; he was able to run and leap with the other boys without being prostrated with the pain as he had been formerly.

    The improvement wrought by osteopathy in this case held good until my friend left Chattanooga with her boys, and I lost track of them for a number of years. Then I learned—about five years ago—that this small boy so providentially rescued from, the allopath's mercurial prescription by the Chattanooga osteopath, had—after twenty years—fallen again into allopathic hands, this time to be rescued only by death. He had made a brilliant record in college and the law school, it seemed, had entered the practice of law in an Eastern city, where he succumbed to influenza soon after acquiring enough money to call in the services of high-placed and high-priced medical specialists. And these—as is too often the case where there is money in the offing—had simply drugged, serumized, spinal-punctured and operated this promising young life into the grave.

    Meantime, in the twenty years that had elapsed since I witnessed the osteopathic demonstration in the small Chattanooga office, the cult of Osteopathy had been gaining adherents and growing in popularity and power. In the winter of 1918, in New York City, chance threw under my observation another providential escape from allopathic wreckage by way of Osteopathy.

    A young baritone singer I knew there, who developed symptoms of pneumonia, was persuaded by some friends of his to send for an osteopath instead of a "regular." The result was not immediate recovery, as the pneumonia dragged its slow length along through two months of tedious illness; and the osteopath in this case evinced none of the indifference to fees remarked of our Chattanooga friend. His ignorance of proper feeding in sickness—quite equaled by allopathic ignorance in similar cases—no doubt accounted for the complication of pleural abscess which set in, and for the slow recovery. In short, the disease described about the same course it would have taken under allopathic ministrations, and with the osteopath's even greater diligence in collecting his fee, the net loss in time and money for the young singer was about the same.

    But the thing which gave him later cause for thankfulness that an osteopath, and not a "regular" had tended him in that illness, was the difference in their methods of treating the pleural abscess which formed after several weeks. Under osteopathic manipulation, this was allowed to break and discharge itself through natural channels; whereas the "regular" treatment for such troubles is to perform a surgical operation known as an "empyema operation," an incision between the ribs for the insertion of an artificial drainage tube of some kind. A very intelligent and well-educated English nurse from Canada whom I met in New York, who had served with hospital units at home and in France during the World War and had seen many such cases, told me an empyema wound rarely ever healed, and when it did was usually followed by other grave complications.

    Many will recall in the published reports at the time of Caruso's last illness, among other tender ministrations served up to him by the medical "experts"—such as constant feeding of highly concentrated protein food—that "an empyema operation was performed." It will also be recalled that the final reading of Caruso's case was that he died from an abscess on the liver. Our more fortunate young baritone who received the osteopathic treatment and escaped the empyema operation, made a final complete recovery with no unhappy sequelæ; and his naturally fine voice which would most likely have been stilled like Caruso's in the hands of the allopaths, was preserved intact.

    I have no first-hand knowledge of osteopathic treatments per se, and cannot testify as to the therapeutic value of this branch of mechano-therapy as a distinct method or system; but the two instances of its use herein recounted which came under my direct observation, were sufficient to convince me that if osteopathy had no other virtue, its value in pulling people away from medical procedure was considerable. Quite a number of other people must have reached a similar conclusion, for Osteopathy to have grown from its humble beginnings with Andrew Still in Kirksville, Missouri, in 1874, to its present respectable proportions and popular recognition. The author of "Medical Follies" devotes the greater portion of his long chapter on Osteopathy— twice the space that he gave to Homeopathy—to ridiculing the illiteracies and eccentricities of dress and manner of its founder, Andrew T. Still. Book-learning-of-sorts being the medical cult's long suit, any rival cult lacking this superficial erudition would be fair game for the medical caricaturist, of course. Andrew T. Still, the man who gave to Osteopathy a habitation and a name among healing cults, is described in the Fishbein chronicle as "early American out of English, Irish, German and Scotch sources." These are pretty good racial stocks, and this being one of the very few accurate statements in Dr. Fishbein's chapter on Osteopathy, we are glad to give it full credit. Still was born in Lee County, Virginia, in 1828, but migrated to Missouri and Kansas in time to imbibe the anti-Slavery sentiment of that section and to fight against his native State in the Civil War of the 6o's. Prior to that he had taken a medical degree from the Kansas City School of Physicians and Surgeons, and had practiced medicine in Kansas before he entered the Union service as an army surgeon.

    Historian Fishbein relates: "It appears likely that his great-grandfather came to Buncombe County, North Carolina, from England; the almost irrelevant fact is cited merely because of the name of the county!" Perhaps Historian Fishbein would regard as "irrelevant" in this connection the story of the little girl who when asked by her teacher to name "the Father of Medicine," fished around in her memory wells for the old Greek's name, and finally stammered out: "It was Hyp—Hyp—Hypocrisy!" Circumstances alter cases for a joke as for other things.

    Dr. Still, though a graduate M.D., a practicing physician of considerable experience, and an Army surgeon for four years, was the rough-and-ready type of country doctor to be found on the Western frontier at that period. Neither from his "Autobiography," nor from any authentic account given of him, does it appear that he could lay claim to great learning or scholarship, or that his manners would grace an Eastern drawing-room. But that does not signify that the system of healing he founded held more buncombe than the one which Dr. Fishbein is striving to prop with such obviously bolstering devices as "Medical Follies." Indeed there are many persons in the world to-day who are not osteopaths, yet who believe that Dr. Still's therapy holds less of buncombe and certainly less of harm, than the prescriptions of orthodox medicine.

    Dr. Fishbein essays to produce a sneering effect by citing the fact that before Andrew Still "flung his osteopathic banner to the breeze" in 1874, he practiced medicine among the Shawnee Indians of Kansas; that "he learned to speak their language and was well received by them." This to our mind speaks very well for Dr. Still. Not all pioneer whites in this country were "well received" by the Indians, and not all of them deserved to be. Again, there seems no good reason for supposing that the Shawnees would afford less valuable material for clinical observation and experiment than a like aggregation of flesh and blood and bone among civilized folks.

    The truth of this appears from the vast sums spent in recent years by cancer experts, in traversing the far places of the earth to study the habits of primitive peoples, and to bring back the only thing of value they have ever learned about cancer—that it is a product of civilization. Some folks might say also, that Dr. Still could have learned medicinal secrets from Indian lore that were of more benefit to his patients than anything he learned in the medical school.

    It is true that Dr. Still early manifested an interest in bones—if that is to his discredit, as Dr. Fishbein apparently thinks it is—and that he sometimes dug them out of Indian mounds and carried them home in a sack on his back. This earned for him the nickname of "the bone doctor," while his other eccentricities of speech and dress excited the ridicule and elicited the sort of persecution that is always meted out to non-conformists in every field by the "regulars" in medicine, in religion, and in politics.

    The underlying principle of Dr. Still's philosophy, that a free circulation of vital fluids—blood and lymph—and unimpeded nerve currents to every part of the body are essential to normal metabolism and healthy living tissues, will not be disputed by the exponents of any school of healing—including the "Regulars." Another tenet of Osteopathy, namely, that specifically calculated movements based on rational principles of physiology and hygiene have a salutary effect on the human organism, was formulated and developed into a system in Europe 100 years before Andrew Still was born.

    Peter Henrik Ling, Swedish poet and linguist who lived from 1766 to 1839, was the son of a clergyman and himself dedicated to the Church; but being in poor health and learning that the art of fencing was a good corrective of gout and rheumatism, he turned from ecclesiastical orders to devote himself to physical culture. From this he evolved the system known as Mechano-therapy, or the "Swedish Movement Cure," which is the legitimate progenitor of all the modern manipulative cults—including Osteopathy and Chiropractic.

    Dr. George H. Taylor, a New York physician who went abroad to study Ling's system and published a book on the subject in 1861, entitled "An Exposition of the Swedish Movement Cure," describes 100 distinct movements included in it in which the subject is both the active and passive agent. It embraced many mechanical devices since employed in gymnasiums. Unlike the less cultured protagonists of its later progeny—Osteopathy and Chiropractic—the founder of Mechano-therapy, it seems, was accorded popular support almost from the beginning. In 1813 he was appointed master of fencing at the Carlsberg Military Academy near the Swedish Capital, and from that he induced the Government to establish in an old armory at Stockholm, the "Central Gymnasium Institute" which was both training school and clinic, with Ling as its first director. It is recorded that "1,500 persons a year attended this Institute, 350 of whom were invalids."

    Dr. Taylor relates that similar institutions—at least thirty—sprang up all over northern Europe, and personally testifies: "There is scarcely any chronic disease known that I have not seen successfuly treated at these institutions, including blindness, deafness, and deformity of various kinds."

    Now if the book, "Medical Follies," were what its author claims for it—an honest attempt to give the various therapeutic cults their proper status and true historic perspective, it could hardly have omitted some mention of Peter Henrik Ling and his Mechano-therapy, which embodying as it did the same central idea as Osteopathy and Chiropractic, was their lawful and dignified forerunner. Yet Historian Fishbein while devoting twenty-eight pages to Osteopathy, and twenty-five to Chiropractic, prefers to give the space to belittling efforts at picking off the personal peculiarities of Still and Palmer, and to reproducing illiterate communications from some of their correspondents, rather than give any fair presentation of the constructive principles embodied in their work.

    So much afraid, apparently, is Dr. Fishbein of lending any sort of countenance to successful rivals in his own field, that he does not even hint at the resemblance between the osteopathic and chiropractic schools and the Swedish Movement Cure of the cultured and scholarly Ling. No, these despised cults must not be permitted to borrow any adventitious respectability from such an association.

    There is no evidence that Andrew T. Still consciously borrowed from Ling in the development of his osteopathic method, although being a medically trained man he may have read Dr. Taylor's book on the Swedish Movement, and may also have been familiar with the works of Dr. Russell Trail— published in Boston as early as 1863—who had specially featured Ling's system. But the theory of "osteopathic lesions"—injuries arising from the pressure on nerves or blood-vessels by a misplaced bone or ligament, or by "a subluxated vertebra"— appears to have been Still's own idea; and the peculiar osteopathic technique for relieving this pressure or impingement, must also be accredited to the founder of the Kirksville School. This was the institution—established in 1894—which the author of "Medical Follies" says "was to deliver upon the people of the United States some thousands of the ignorant followers of the osteopathic system of diagnosing and treating disease."

    I hold no brief for the osteopathic method of "diagnosing and treating disease," and a layman's judgment of such things does not go anyway, particularly with the Scribes and Pharisees of the medical profession. But I have in my possession a communication (date November 18, 1925) from Dr. Richard C. Cabot, professor of Medicine in the Harvard Medical School and Senior Consultant at the Massachusetts General Hospital, containing the statement over his own signature that "from 20 to 80 per cent of medical diagnoses are wrong, depending on the disease diagnosed."

    I have no osteopathic figures with which to compare these medical findings furnished by Dr. Cabot, and we know nothing except by comparison. We can only speculate as to whether or not the osteopaths can beat the medical men at the game of guessing and naming diseases. Dr. Cabot's figures, it is understood, were compiled from post-mortem examinations at the Massachusetts General Hospital; and one very interesting feature about them has been pretty generally overlooked. This is, that the post-mortem subjects which confirmed the doctor's diagnoses were just as dead as the dead ones which proved him wrong!

    In other words, the M.D.'s manifested no greater skill in getting the patient well when they did know what his trouble was than when they didn't, according to the mortuary findings reported by Dr. Richard C. Cabot. And the important point to emphasize in this connection is, that the patient would like to live and get well, regardless of the particular name —usually beyond his ken anyway—which the doctor may choose to affix to his ailment. Doctors are sometimes prone to overlook the patient's attitude in their engrossed preoccupation with things like diagnosis and signing death certificates.

    And right here it seems appropriate to call attention to the fact, that while we have no osteopathic data on diagnosis, for purposes of comparison with the "regulars," we have some figures compiled by a well-known osteopath of New York City, which show the comparative mortality among patients under medical and under osteopathic care during the "Flu" epidemic of 1918-19. These medical figures were obtained from estimates based on the reports of 148 Health Commissioners—24 of them State Health Commissioners—together with estimates of the National Census Bureau and several large Insurance Companies. From these, a very conservative estimate places the fatalities in influenza cases under medical care at 6 to 7 per cent. The mortality percentage under osteopathic treatment was obtained from report blanks furnished all practicing osteopaths in the United States and Canada for data on all cases of influenza and pneumonia. Strict instructions went with these report blanks to report only well-developed cases, and to report all such with all fatalities. All told, 2,445 osteopathic practitioners reported; but these covered every section of the Union and Canada, small towns as well as large cities, and 110,122 cases of influenza were reported with only 257 deaths, or a mortality rate of about one-fourth of 1 per cent.

    If it be objected that this is given only on osteopathic authority, we may ask the objector, upon whose authority are medical statistics compiled? And when both the vital statistics and the diagnosis are left in the same hands—with none to molest or make him afraid—what is easier than to make the figures tally with the statistician's inclinations?

    The osteopathic statistician in this case is an ex-president of the New York Osteopathic Society, ex-president of the American Osteopathic Association, and chairman of their Bureau of National Legislation. He was also chosen to write the article on Osteopathy for the Encyclopedia Britannica in 1922. Those who wish to contend that an osteopathic statistician is not as reliable as a medical statistician—other things being equal, are simply affixing the stigma of pharisaism to the medical profession.

    According to the Encyclopedia Britannica article, the osteopathic profession in 1921 comprised over 7,000 graduate practitioners, and maintained six other flourishing colleges in the United States besides the parent school at Kirksville, the largest in the world, and reputedly the equal in size and equipment with the best medical schools in this country. Osteopaths now claim that the entrance requirements of all their colleges are as high as the medical requirements; that their student enrollment is second only to that of the allopaths; and that their curricula embrace all the subjects taught in the medical schools except Materia Medica for which they substitute "Principles and Practice of Osteopathy." The course of study is four years of at least eight months each, spent in actual attendance at one of the recognized osteopathic colleges.

    Indeed so closely has Osteopathy followed the allopathic pattern in some respects that certain allopathic leaders have viewed its encroachments with alarm. Dr. Channing Frothingham of Boston, writing in the Atlantic Monthly (1923) on "The Established Facts of Medicine" (we had been wondering what they were), makes a brave effort to explain away the growing popularity of the manipulative cults, and accounts for Osteopathy's success by its more recent tendency to square its faith and practice with "The Established Facts." Dr. Frothingham makes a curious admission in this connection. He says: "In that group of diseases in which the nature of the abnormal process is not well understood"—which group embraces 20 to 80 per cent of the cases, according to Dr. Cabot—"it is quite evident from individual reports, that osteopathic treatment in some of these ill-defined cases gives relief; and in some instances even after regular physicians have failed to make the patient comfortable." (Italics mine.)

    Dr. Frothingham denies, however, that there is "any satisfactory proof of the value of osteopathic treatment in diseases of recognized pathology." Seeing that so little of the pathology is recognizable by the allopaths (upon the authority of Dr. Cabot and others), this would seem to concede the greater osteopathic efficiency in the matter of diagnosing disease; and in view of the emphasis the allopaths place on the importance of diagnosis, this looks like a tremendous concession.

    Dr. Fishbein, being "an artful person," makes no such damaging admissions in his "Medical Follies." He will concede no merit in any rival healing cult. He sees in the modern osteopath's efforts to hew to the line of regular medical procedure, only an evidence of weakness—a confession of failure of his own peculiar tenets, and "an attempt to break into the practice of medicine by the back door."

    There are osteopaths who will hurl back this Fishbein allegation with the retort: Any osteopath caught sneaking into regular medicine through the back door, does so because he is ashamed to be seen going in the front way—as he ought to be! There are others, unfortunately, whose obvious aping of the "regulars" lends some color to Dr. Fishbein's charge. The reason for such conformity, however, is not—as Dr. Fishbein would make it appear—osteopathic recognition of the greater efficiency of medical procedure; but because the osteopath, like the homeopath, bows to the expediency of compromise with the medical system which is politically dominant in the State.

    Why should osteopaths, for example, who lost only one patient in 428 during the "flu" epidemic, go to the allopaths who lost one in 16, to learn how to care for the sick? If we concede the Fishbein and Frothingham contention that there is no efficacy in osteopathic treatment per se, then the only other obvious explanation of the better luck of the osteopaths' patients in that crisis, is that through Osteopathy they escaped the medical dope. There is little ground for Allopathy's preening of itself upon either supposition.

    I will close this discussion of the comparative claims of Osteopathy and Regular Medicine, by citing the now famous case of Sir Herbert Barker, the London osteopath knighted by the King for his signal services to the British soldiery during the World War. An English allopath, Dr. Axham by name, became curious about Sir Herbert's work, it seems, and "sneaked" into the osteopath's treating rooms. Whether he entered by the back door or the front, I am not informed, but apparently he didn't go in quietly enough to escape the espionage of the British Medical Council who, when they learned that he had served as anaesthetist to Sir Herbert Barker, promptly expelled Dr. Axham from the Council. This superb act of intolerance and stupidity caused the Irish Free State Government to sever the connection of Irish doctors with the British General Medical Council, and drew from George Bernard Shaw—who it is claimed had derived personal benefit from Osteopathy—a characteristic philippic against the medical hierarchy in general and the British Council in particular. Shaw's long letter in the London Times, anent the affair contained some things so true and pertinent about medical autocracy everywhere, as to be worth quoting and remembering.

    He said: "The Free State Government will, I hope, resolutely carry out its announced intention of rescuing Ireland from the disastrous control of that despised and self-disgraced trade union—the British Medical Council. . . . The most famous manipulative surgeon in England, knighted for his services though being unregistered, is denounced as a quack by men of whom some, though registered as competent surgeons, are hardly dexterous enough to manipulate their own shoe-laces. The Council avenges itself for this public slight of knighthood by threatening to strike off the register as guilty of infamous professional conduct, any registered doctor who acts as anæsthetist to the knight. . . . The General Medical Council has about as much to do with science as the Miners' Federation has to do with geology and mineralogy. Even in the medical world, which is not the scientific world, it has no preeminence, and in both Europe and America it is a laughing-stock. The medical profession in Ireland will lose no prestige by dissociating themselves from it. But now comes a serious question: Will an Irish Council prove any better? I answer certainly not if the Irish Government acts as stupidly and ignorantly in this matter as the English Government. . . . President Cosgrove's sensible announcement contained one terrifying phrase—'self-controlled profession.' . . . A self-controlled profession is a conspiracy against the laity. And of all professions on earth, the medical profession, consisting mainly of private medical and surgical practitioners who have a direct pecuniary interest in making us ill, keeping us ill and mutilating us, is one that needs the sternest disinterested control, not only in the common interest of the general body of citizens, but in that of science." 

     

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