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Osteopathy

Osteopathy

Definition

Osteopathy is a "whole person" philosophy of medicine, where doctors of osteopathic medicine (DOs) endorse an approach that treats the entire person, rather than a specific complaint. Attention is given to prevention, wellness, and helping the body to heal itself. Because the body is viewed as a single organism or unit, special focus is given to understanding body mechanics and the interrelationship of the body's organs and systems. A particular emphasis is placed on the musculoskeletal system. Dos may utilize physical manipulation of muscles and bones in conjunction with, or as an alternative to, conventional treatments, drug therapies, and surgery to provide complete health care.

Origins

Dr. Andrew Still developed the osteopathic approach to medicine. Still, whose father was a Methodist minister and physician, was himself a medical doctor who served as a Union surgeon during the Civil War. After the war, personal tragedy struck the Still household when three of his children died from spinal meningitis . This event angered and disillusioned him. He became dissatisfied with the state of medical knowledge and treatments available at that time. Consequently, he began an intense study of the human body to find underlying causes and cures for ailments.

Still gave great attention to anatomy. He recognized the importance of the musculoskeletal system, the body's ability for self-healing, and focused on prevention and the concept of "wellness." In an era when drug treatment was frequently dangerous and overused, and surgery often fatal, Still was able to develop alternative treatments. For example, by manipulating the ribs and spine, Still provided treatments for pneumonia . He gave attention to the lymphatic system (which filters foreign matter and removes excess fluids, proteins, and waste products from the tissues and transports them to the blood to be circulated and eliminated) and manipulating the fascia (connective tissue that is tough, but thin and elastic; it forms an uninterrupted three-dimensional network from head to foot, sheathing every muscle, bone, nerve, gland, organ, and blood vessel), allowing him to address a range of other ailments.

Still's sons learned his philosophies and techniques, but demand overwhelmed their ability to supply care. In 1892, Still founded the first college of osteopathic medicine, the American School of Osteopathy, in Kirksville, Missouri. When he died in 1917, there were more than 5,000 practicing osteopaths in the United States. Today, osteopaths are the fastest growing segment of the total population of physicians and surgeons in the United States. In 2002, there were more than 49,000 doctors of osteopathy. Osteopathy has spread outside of the United States and is now practiced in countries throughout the world.

Benefits

The osteopathic focus on prevention and wellness may help individuals to avoid illness by teaching healthy behaviors and encouraging health-promoting lifestyle changes. In addition to conventional treatments, drugs, and surgeries, DOs may offer manipulative therapies not available from their allopathic counterparts MDs). Many people seek care from an osteopath for back or neck pains, joint pains, or injuries. However, DOs may use manipulative therapies to treat a variety of ailments and conditions including arthritis, allergies, asthma, dizziness, carpal tunnel syndrome , menstrual pain , migraine headaches, sciatica , sinusitis, tinnitus (ringing in the ears), and problems in the jaw joints. Manipulative therapies may be incorporated into the treatment plan to speed recovery from various conditions, such as heart attack or disc surgery, and to address pediatric concerns, such as otitis media (ear infection ) and birth traumas. Various manipulative therapies may also be appropriate in alleviating discomforts associated with pregnancy , for example, back pain or digestive problems. Some osteopaths even feel that regular osteopathic treatments may help minimize the effects of aging on the spine and joints. Also, as noted by the American Osteopathic Association (AOA), the field of sports medicine has found particular benefit in osteopathic practitioners because of their emphasis on "the musculoskeletal system, manipulation, diet, exercise , and fitness. Many professional sports team physicians, Olympic physicians, and personal sports medicine physicians are DOs."

Description

Osteopathic medicine considers the human body to be a complex unit of interrelated parts, a unified organism. Organs and systems do not function independently and should not be treated as such. A disturbance in one part of the body affects the entire body. Illness is also impacted by many variables, such as emotions, stress , lifestyle, and environment. Therefore, illness must be addressed by taking a whole person approach to treatment. Because the body is seen as self-regulating and self-healing, the osteopath gives special attention to illness prevention and helping the body maintain or re-establish wellness.

The nervous and circulatory systems play crucial roles in maintaining the functioning of the body's organs and systems; negative body-wide effects may occur when these two major systems are not functioning optimally. Relieving blocked blood flow or nerve impulses will help the body to heal itself by promoting blood flow through affected tissues. The blood supply will be better able to deliver vital nutrients and boost the immune system, the nerve supply to the area will be improved, and systemic balance can be restored.

The musculoskeletal system is key in this effort to achieve and maintain systemic balance and health. The musculoskeletal system is comprised of the bones, tendons, muscles, tissues, nerves, and spinal column. As the body's largest system, it encompasses over 60% of body mass and can suffer mechanical disorders or amplify illness processes anywhere in the body. Therefore, structural evaluation and attention to the musculoskeletal system is central to osteopathy.

In addition to conventional care such as drug therapies and surgery, osteopaths may use a variety of manipulative procedures to help the body systems function at peak levels. These techniques are commonly referred to as Osteopathic Manipulative Treatment (OMT). OMT is a form of noninvasive, "hands-on" care used for prevention, diagnosis, and treatment to reduce pain and restore motion, as well as help the body heal itself. OMT may be used to facilitate the movement of body fluids and normal tissue functioning, and release painful joints or dysfunctional areas. These therapies take different forms depending on patient needs.

In addition to easing the pain of physical disorders, OMT appears to be helpful in some psychiatric conditions as well. A recent study performed at the College of Osteopathic Medicine in Downers Grove, IL, found that OMT as an adjunct to psychotherapy alleviated the symptoms of depression in women, as measured by the Zung Depression Scale, a standard diagnostic instrument.

ANDREW TAYLOR STILL 18281917


Andrew Taylor Still, the father of osteopathy, was born on August 6, 1828, in Virginia to Abram and Martha Still. Growing up on the frontier lands of Tennessee and Missouri provided the impetus for his first studies of the musculoskeletal system. Skinning squirrels and deer, Still became familiar with the relationship between bones, muscles, nerves, and veins long before he picked up an anatomy book. He later studied medicine under his doctor-preacher father and served as a Union surgeon during the Civil War.

Following the war, his distrust of traditional medicine grew when three of his children died of cerebrospinal meningitis . Still decided that the medications of his day were useless and that there had to be another way.

Still studied the attributes of good health so he could understand disease. He saw the body as a complex machine that, when working properly, stayed free of disease. He turned to a drugless, manipulative therapy believing disease was caused by a failure of the human machinery to carry the fluids necessary to maintain health. He called his holistic approach osteopathy for the Greek words osteon, meaning bone, and pathos, to suffer.

Still gained a following working as an itinerant healer, and in October 1892, he opened the American School of Osteopathy in Kirksville, Missouri. Still welcomed women even as other medical schools denied them access.

As of 2000, there were 16 osteopathic medicine colleges in the United States and 35,000 practicing doctors of osteopathy. The Kirksville College of Osteopathic Medicine remains open.

Manipulative procedures may be categorized and discussed in a variety of ways. According to the American Association of Colleges of Osteopathic Medicine, the following groupings encompass some of the most commonly used procedures. Descriptions are compiled from the American Academy of Osteopathy, Leon Chaitow, N.D., DO, and others.

  • Articulatory techniques. Procedures that move joints through their range of motion (articulating the joints) may be used to restore normal functioning.
  • Counterstrain. This type of therapy is used to alleviate trigger points localized areas of hyperirritability in the muscles). The procedure involves first finding a body position that relieves the patient's pain. Through a process in which the patient and practitioner repeatedly use coordinated techniques of pushing (or compression), relaxing, and changing position, the trigger point is eased.
  • Cranial treatment. Cranial treatments focus on the craniosacral system which consists of the brain, spinal cord, cerebrospinal fluid, dura (the membrane covering the brain and spinal cord), cranial bones, and the sacrum (triangular bone comprised of five fused vertebrae, and forming posterior section of the pelvis). Craniosacral release is a gentle technique that focuses on normalizing imbalances in the natural rhythms of this system. A light touch is used to detect and release restrictions in the system and encourage the body's own healing processes. Craniosacral therapies arose from the work of Dr. William Sutherland, a DO who developed and explored the concept that the bones of the skull allowed movement and could be manipulated to improve the system's rhythmic movements. Some DOs choose to specialize in cranial osteopathy. Craniosacral therapy is also practiced by a wide variety of health care professionals. As listed by the Upledger Institute, these practitioners include MDs, chiropractors, doctors of Oriental medicine, naturopaths, nurses, psychiatric specialists, psychologists, dentists, physical therapists, occupational therapists, acupuncturists, massage therapists, and other professional bodyworkers.
  • Myofascial release treatment. Various direct or indirect treatments are applied to release fascia tissues.
  • Lymphatic techniques. These techniques focus on improving lymphatic circulation, improving the ability of the lymphatic system to do its job of waste removal.
  • Soft tissue techniques. Applied to tissue other than bone, these techniques use varying pressure and may stretch, roll, or knead, resulting in the relaxation or release of tissues.
  • Thrust techniques. A quick, sharp thrust (which is often described as high velocity/low amplitude) to the area requiring treatment is used to force a correction, restoring normal joint function and movement. This is similar to chiropractic adjustment.

Precautions

DOs use the full range of conventional diagnostic techniques, drug therapies, treatments, and surgical interventions available to MDs. If deemed appropriate by the DO, OMT may be employed in addition to these conventional diagnoses, and treatments or may serve as an alternative to drug therapies. During the course of treatment, manipulative therapies may be interrupted or stopped if complications occurfor example, a rise in blood pressure. In some situations, the osteopath may determine that no further benefit will be gained from continuing manipulative treatment. Manipulation should not be applied in several medical conditions. As listed by Chris Belshaw, these conditions are mainly "acute infections ; fractures ; bone disease; cancer ; gross structural deformities; such severe general medical conditions as gross high blood pressure or heart attack; vascular disease, for example, thrombosis; neurological conditions with nerve damage; spinal cord damage; and severe prolapse of an intervertebral disc." Additionally, as in any area of medicine, there is the possibility of mistaken diagnosis. Patients should always discuss all medical conditions, treatments, questions, and concerns with their physicians.

Side effects

Some patients, as noted by Belshaw, may experience mild headaches following neck treatments or discomfort after back manipulation. Some flushing and bruising may appear on those with sensitive skin. These reactions may last for several hours. Such symptoms may recur as treatment continues. Symptoms may return if treatment is stopped too soon.

Research & general acceptance

Research has shown the benefits of osteopathic care in a range of ailments and through improved recovery times. In addition to many of the conditions discussed above, the American Osteopathic Healthcare Association reports ongoing research on patient recovery times, length of hospital stays, chronic pain, chlamydia infection in women, reduction of deep vein thrombosis, and fall prevention for the elderly. Osteopathic colleges have increased their attention to biomedical research opportunities for students and those who desire to pursue research careers. The AOA Board of Research encourages and supports development of scientific research in the osteopathic medical profession. The AOA has also conducted several campaigns to educate the public on osteopathy. In 2000, the AOA started a Women's Health Initiative, a three-year campaign to promote women's healthcare among osteopathic physicians and the public.

Training & certification

Training and certification for DOs exceed those of chiropractors and physical therapists, two groups to which their manipulative techniques are sometimes compared. Chiropractic training focuses on spinal manipulation only. Chiropractors typically have fewer years and types of required postgraduate training, and are more limited legally in their practice. DOs also have training and licensing well beyond that of physical therapists.

Osteopathic physicians, like their allopathic physician counterparts, are complete physicians. This means they are trained and licensed to prescribe medication and perform surgery, and qualified to render complete healthcare. DOs are fully licensed in all 50 states and the District of Columbia, to serve in the military medical corps, Veterans Administration, and Public Health Service, and are recognized by the American Medical Association as physicians. They hold the same practice rights as MDs, have passed the same or similar state licensing examinations, and practice in fully accredited hospitals. DOs can practice in all branches of medicine and surgery, and can specialize in any area, but the majority are primary care physicians.

As of spring 2002, the AOA lists 20 AOA-accredited colleges of osteopathic medicine. Training for DOs and MDs parallel in many ways. Osteopathic colleges, like medical schools, offer a basic, comprehensive four-year medical education. Added to this curriculum are the osteopathic philosophies and a holistic care emphasis on prevention and community care. In addition to stressing the inter-relatedness of body organs and systems, students of osteopathy are taught to consider the whole person, including lifestyle, emotional factors, and environmental factors. Training also focuses on the musculoskeletal system and manual medicine. Manipulative therapies are taught for prevention, diagnosis, and treatment, and the osteopathic principle of helping the body toward good health.

After graduation from the four-year curriculum, DOs complete a one-year rotating internship, followed by several years in a residency program, if a specialty is desired. The areas covered during the internship period ensure that each DO is first trained as a primary care physician. Over half of all DOs are primary care physicians. Conversely, MDs are more likely to be specialists.

After the formal education process, the AOA requires members to earn continuing medical education (CME) credits every three years. To further enhance postgraduate medical education, the AOA has implemented the concept of Osteopathic Postdoctoral Training Institutions (OPTIs), which reflect the osteopathic emphasis on community care. These OPTIs are community-based consortia that include at least one hospital and college of osteopathic medicine. The intention of these is to promote institutional collaboration and enhance training opportunities that reflect the settings in which many osteopaths will practice. In early 2002, a new Osteopathic Research Center opened at the University of North Texas Health Science Center in Fort Worth. The new Research Center is the result of collaboration among the American Colleges of Osteopathic Medicine, the American Osteopathic Foundation, and the American Osteopathic Association.

Many aspects of traditional osteopathic philosophy, such as advice about diet and smoking , have entered mainstream medicine to the point that the lines between DOs and MDs are blurring. In addition, the dedication of osteopaths to holistic medicine and primary care has been a great benefit to rural areas of the United States that are often underserved by mainstream practitioners.

Resources

PERIODICALS

"Osteopathic Manipulative Treatment May Benefit Patients." Health & Medicine Week (October 8, 2001).

Patrick, Stephanie. "Fort Worth Chosen for Osteopathic Center." Dallas Business Journal 25 (October 26, 2001): 10.

Shepard, Scott. "Health Philosophies on Common Ground." Cincinnati Business Courier 18 (November 9, 2001): 38.

ORGANIZATIONS

American Association of Colleges of Osteopathic Medicine. 5550 Friendship Blvd., Suite 310, Chevy Chase, MD 20815-7231. (301) 968-4100. <http://www.aacom.org>.

American Osteopathic Association. 142 E. Ontario Chicago, IL 6061. (800) 621-1773. info@aoa-net.org. <http://www.aoa-net.org>.

The Upledger Institute, Inc. 11211 Prosperity Farms Road, D-325, Palm Beach Gardens, FL 33410-3487. Educational services: (800) 233-5880. Administration: (561) 622-4334. Fax: (561) 622&-4771. upledger@upledger.com. <http://www.upledger.com>.

OTHER

HealthWorld Online. "Osteopathy." [cited October 2002]. <http://www.healthy.net/CLINIC/therapy/Osteo/Index.asp>.

The Osteopathic Homepage. <http://www.osteohome.com>.

Rebecca J. Frey, PhD

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Frey, Rebecca. "Osteopathy." Gale Encyclopedia of Alternative Medicine. 2005. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

Frey, Rebecca. "Osteopathy." Gale Encyclopedia of Alternative Medicine. 2005. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1G2-3435100585.html

Frey, Rebecca. "Osteopathy." Gale Encyclopedia of Alternative Medicine. 2005. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1G2-3435100585.html

Osteopathy

Osteopathy

Definition

Osteopathy is a system and philosophy of health care that separated from traditional (allopathic) medical practice about a century ago. It places emphasis on the musculoskeletal system, hence the nameosteo refers to bone and path refers to disease. Osteopaths also believe strongly in the healing power of the body and do their best to facilitate that strength. During this century, the disciplines of osteopathy and allopathic medicine have been converging.

Purpose

Osteopathy shares many of the same goals as traditional medicine, but places greater emphasis on the relationship between the organs and the musculoskeletal system as well as on treating the whole individual rather than just the disease.

Precautions

Pain is the chief reason patients seek musculoskeletal treatment. Pain is a symptom, not a disease by itself. Of critical importance is first to determine the cause of the pain. Cancers, brain or spinal cord disease, and many other causes may be lying beneath this symptom. Once it is clear that the pain is originating in the musculoskeletal system, treatment that includes manipulation is appropriate.

Description

History

Osteopathy was founded in the 1890s by Dr. Andrew Taylor, who believed that the musculoskeletal system was central to health. The primacy of the musculoskeletal system is also fundamental to chiropractic, a related health discipline. The original theory behind both approaches presumed that energy flowing through the nervous system is influenced by the supporting structure that encase and protect itthe skull and vertebral column. A defect in the musculoskeletal system was believed to alter the flow of this energy and cause disease. Correcting the defect cured the disease. Defects were thought to be misalignmentsparts out of place by tiny distances. Treating misalignments became a matter of restoring the parts to their natural arrangement by adjusting them.

As medical science advanced, defining causes of disease and discovering cures, schools of osteopathy adopted modern science, incorporated it into their curriculum, and redefined their original theory of disease in light of these discoveries. Near the middle of the 20th century the equivalance of medical education between osteopathy and allopathic medicine was recognized, and the D.O. degree (Doctor of Osteopathy) was granted official parity with the M.D. (Doctor of Medicine) degree. Physicians could adopt either set of initials.

However, osteopaths have continued their emphasis on the musculoskeletal system and their traditional focus on "whole person" medicine. As of 1998, osteopaths constitute 5.5% of American physicians, approximately 45,000. They provide 100 million patient visits a year. From its origins in the United States, osteopathy has spread to countries all over the world.

Practice

Osteopaths, chiropractors, and physical therapists are the experts in manipulations (adjustments). The place of manipulation in medical care is far from settled, but millions of patients find relief from it. Particularly backs, but also necks, command most of the attention of the musculoskeletal community. This community includes orthopedic surgeons, osteopaths, general and family physicians, orthopedic physicians, chiropractors, physical therapists, massage therapists, specialists in orthotics and prosthetics, and even some dentists and podiatrists. Many types of headaches also originate in the musculoskeletal system. Studies comparing different methods of treating musculoskeletal back, head, and neck pain have not reached a consensus, in spite of the huge numbers of people that suffer from it.

The theory behind manipulation focuses on joints, mostly those of the vertebrae and ribs. Some believe there is a very slight offset of the joint membersa subluxation. Others believe there is a vacuum lock of the joint surfaces, similar to two suction cups stuck together. Such a condition would squeeze joint lubricant out and produce abrasion of the joint surfaces with movement. Another theory focuses on weakness of the ligaments that support the joint, allowing it freedom to get into trouble. Everyone agrees that the result produces pain, that pain produces muscle spasms and cramps, which further aggravates the pain.

Some, but not all, practitioners in this field believe that the skull bones can also be manipulated. The skull is, in fact, several bones that are all moveable in infants. Whether they can be moved in adults is controversial. Other practitioners manipulate peripheral joints to relieve arthritis and similar afflictions.

Manipulation returns the joint to its normal configuration. There are several approaches. Techniques vary among practitioners more than between disciplines. Muscle relaxation of some degree is often required for the manipulation to be successful. This can be done with heat or medication. Muscles can also be induced to relax by gentle but persistent stretching. The manipulation is most often done by a short, fast motion called a thrust, precisely in the right direction. A satisfying "pop" is evidence of success. Others prefer steady force until relaxation permits movement.

Return of the joint to its normal status may be only the first step in treating these disorders. There is a reason for the initial event. It may be a fall, a stumble, or a mild impact, in which case the manipulation is a cure. On the other hand, there may be a postural misalignment (such as a short leg), a limp, or a stretched ligament that permits the joint to slip back into dysfunction. Tension, as well as pain, for emotional reasons causes muscles to tighten. If the pain has been present for any length of time, there will also be muscle deterioration. The osteopathic approach to the whole person takes all these factors into account in returning the patient to a state of health.

Other repairs may be needed. A short leg is thought by some to be a subluxation in the pelvis that may be manipulated back into position. Other short legs may require a lift in one shoe. Long-standing pain requires additional methods of physical therapy to rehabilitate muscles, correct posture, and extinguish habits that arose to compensate for the pain. Medications that relieve muscle spasm and pain are usually part of the treatment. Psychological problems may need attention and medication.

Risks

Manipulation has rarely caused problems. Once in a while too forceful a thrust has damaged structures in the neck and caused serious problems. The most common adverse event, though, is misdiagnosis. Cancers have been missed; surgical back disease has been ignored until spinal nerves have been permanently damaged.

Normal results

Many patients find that one or a series of manipulations cures long-standing pain. Other patients need repeated treatments. Some do not respond at all. It is always a good idea to reassess any treatment that is not producing the expected results.

Resources

ORGANIZATIONS

American Association of Colleges of Osteopathic Medicine. 5550 Friendship Blvd., Suite 310, Chevy Chase, MD 20815-7231. (301) 968-4100. http://www.aacom.org.

American Osteopathic Association. osteomed@wwa.com http://www.am-osteo-assn.org.

KEY TERMS

Orthotics Mechanical devices that assist function.

Prosthetics Mechanical devices that replace missing body parts.

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Polsdorfer, Ricker. "Osteopathy." Gale Encyclopedia of Medicine, 3rd ed.. 2006. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

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osteopathy

osteopathy first developed from the 1870s onwards in America, under the initial inspiration and guidance of Andrew Taylor Still (1828–1917), who claimed to have discovered a revolutionary new system of healing and an associated therapeutic philosophy. These were based upon two related principal elements; that the healthy body already contained all the relevant capacities for maintaining itself, and that it thus did not need the drug-based remedies of the day. These views at that time were not original, but they were combined with Still's description of ‘osteopathic lesions’. These lesions, unless treated through his system of manual manipulation, were said to disturb the necessary internal balances of the body. Their occurrence became the controversial cornerstone of a distinctive osteopathic pathology. They were thought to be morbid alterations in tissue: muscular, osseous, visceral, ligamentous, or a combination of some or all of those in individual cases. In particular, osteopathic lesions were linked to inadequate articulation of the various parts of the musculo-skeletal system, particularly regarding the condition of the spinal vertebrae. In Still's view, improper articulation produced a disposition to various types of disease, by affecting the neurological system and the circulation of blood and body fluids which were essential to good health.

The social context of the latter decades of nineteenth-century rural America provided a supportive background for Still's beliefs and his related therapeutic evangelism. He was an ‘untrained’ medical practitioner by modern standards, but, as was common in his day, learnt medicine through apprenticeship to his father. He was in practice for many years in Missouri before becoming increasingly interested in bone setting in the 1870s in Kirksville. This was an ancient craft, and the prevailing medical ridicule of it had recently been brought into question. The distinguished London surgeon, Sir James Paget, had published an article, ‘On the Cases that Bone Setters Cure’ in the British Medical Journal. This was followed by Wharton Hood's book On Bone Setting (1871), published in Britain and America. Hood, a general practitioner, was interested in the movements of flexion and extension, combined with external pressure, used by bone setters for back injuries. As Gevitz, a noted historian of osteopathy, points out, at that time Still may have picked up and refined elements of practice which existed in his environment. At this historical point many of the more drastic drug and surgical remedies of conventional doctors did not inspire public confidence, and Still with his ‘new’ methods worked within a tradition of bone setting which was at least familiar to his rural patients. His mechanical theory of health and disease, of aligned and misaligned parts, akin almost to malfunctions of farm machinery, dovetailed nicely with the cultural beliefs of Still's patients.

However, this period was only the starting point of osteopathy's subsequent growth as a rival and different system of practice to medicine in the twentieth century. Still founded a school in 1892 in Kirkville, Missouri, and from this a small group of graduates went on in 1911 to found the British Osteopathy Association. In both countries decades of medical professional opposition to osteopathy followed, but these disagreements had very different outcomes in the two countries, both for medicine and for osteopathy. In the American case, conflict has led eventually to a kind of integration: a movement by practitioners from their initial adherence to Still's beliefs to broadly accepting those of orthodox medicine. Indeed, by the turn of the century the first osteopathic colleges were already teaching some of the medical pharmacopoeia of the day, and gradually pharmacology was brought into osteopathic education and practice. By the 1960s all restrictions on osteopathy as a one-time marginal cult were disappearing, leading to eligibility for medical residencies, and appointment to hospital medical staffs and to positions in the military and public health services. In this gradual process of absorbing and sharing of notions of scientific practice with orthodox medical practitioners, American osteopathic practitioners made manipulation a part rather than the core of their practice.

In Britain and its Commonwealth, professional developments between the two groups have been somewhat different, reflecting in turn their varying social and legal contexts. In Britain osteopaths sought in the 1920s and 30s to secure from the Government the right to practise as independent but different medical practitioners. Eventually this pressure led in 1935 to a Parliamentary Select Committee enquiry into their case, conducted adversarially between two different systems of philosophy and treatment. Eight hundred leading allopathic medical and biological scientists asserted that osteopathy disputed the very basis of modern medical and surgical practice, and that in particular osteopathic lesions could not be affirmed by any objective scientific scrutiny. The osteopaths were not successful in their case for licensing or state registration. Thus they practised under marginalized conditions outside of the National Health Service for forty years after its inception in 1948. By the early 1990s, however, much had changed. Osteopaths had practised successfully for decades as private practitioners; back problems were a major cause of absence from work and were recalcitrant to conventional treatments, and furthermore medical and public attitudes had changed. British osteopaths now presented themselves as complementary practitioners specializing in biomechanics and the manipulation of the musculo-skeletal system. Although extensively trained in basic medical sciences, they did not claim the wider competence of conventionally trained doctors regarding treatment as in earlier decades. In 1993 osteopaths in Britain gained state registration and formal recognition, not so much as an adjusted part of medicine as in America, but as skilled colleagues, akin to physiotherapists, specializing in rather than diminishing the role of manipulation in the treatments they offered.

Gerry Larkin

Bibliography

Gevitz, N. (1982). The D.O.'s: osteopathic medicine in America. John Hopkins University Press, Baltimore.
Wardell, W. (1994). Alternative medicine in the United States. Social Science and Medicine, 38 (8), 1061–8.

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Osteopathy

OSTEOPATHY

OSTEOPATHY is a system of medicine in which the structure and functions of the body are given equal importance and advocates the body's natural ability to heal itself under the right conditions. Focusing on the "rule of artery," osteopaths manipulate body joints in an effort to improve circulation. The frontier physician Andrew Taylor Still (1828–1917) developed the system in 1874 while living in Kansas. As Still's system of treatment evolved, he attempted to present his methods to the faculty of Baker University in Kansas but was turned away. Without the support of the medical community or any patients, Still made his living as an itinerant doctor until his popularity grew enough for him to establish an infirmary. He settled in Kirksville, Missouri, in 1889. Just three years later, Still opened the American School of Osteopathy (later renamed Kirksville College of Osteopathic Medicine); the school was chartered a year later. The first graduating class of seventeen men and five women studied under Still, his sons, and other doctors. Dr. James Littlejohn and Dr. William Smith—Smith, the first to be awarded the Doctor of Osteopathy (D.O.) degree, from Scotland—played important roles in the growth of the school and popularity of osteopathy. In 1897, the American Association for the Advancement of Osteopathy, later called the American Osteopathy Association, and the Associated Colleges of Osteopathy were formed. Once organized into professional associations, osteopaths began to formalize educational and professional standards. In 1905, a three-year course of study was developed; in 1915, the course was increased to four years. As the profession grew, it received recognition from governmental departments as well as the Department of Defense, which granted officer rank to osteopathic doctor volunteers. By the close of the 1970s, Doctors of Osteopathy held full practice rights in all fifty states. In 1982, more than twenty thousand doctors of osteopathy were practicing in the United States.

BIBLIOGRAPHY

Wardwell, Walter I. Chiropractic: History and Evolution of a New Profession. St. Louis, Mo.: Mosby-Year Book, 1992.

Lisa A.Ennis

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osteopathy

osteopathy (ŏstēŏp´əthē), practice of therapy based on manipulation of bones and muscles. This school of medicine, founded by A. T. Still in 1874, maintains that the normal body produces forces necessary to fight disease and that most ailments are due to "structural derangement" of the body. Frequent slight strains are held to be capable of causing misalignment of bones and various other conditions of the muscle tissue and cartilage, and treatment is directed toward correction of these conditions.

The first school of osteopathy was founded at Kirksville, Mo., in 1892. A growing number of other colleges in the United States are accredited by the American Osteopathic Association to give the required four-year course of training and to grant the degree of D.O. (Doctor of Osteopathy). These colleges give a complete course of instruction in conventional medicine as well as in osteopathic theory and practice. Osteopaths are licensed to practice medicine, including surgery and the prescription of drugs, throughout the United States. Many specialize in treating bone and muscle conditions, but about half are primary-care physicians in general medical practice.

See E. R. Booth, History of Osteopathy and Twentieth-Century Medical Practice (1924); E. H. Bean, The Spirit of Osteopathy (1956); J. M. Hoag, Osteopathic Medicine (1969).

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"osteopathy." The Columbia Encyclopedia, 6th ed.. 2016. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

"osteopathy." The Columbia Encyclopedia, 6th ed.. 2016. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1E1-osteopat.html

"osteopathy." The Columbia Encyclopedia, 6th ed.. 2016. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1E1-osteopat.html

osteopathy

os·te·op·a·thy / ˌästēˈäpə[unvoicedth]ē/ • n. a branch of medical practice that emphasizes the treatment of medical disorders through the manipulation and massage of the bones, joints, and muscles. DERIVATIVES: os·te·o·path / ˈästēəˌpa[unvoicedth]/ n. os·te·o·path·ic / ˌästēəˈpa[unvoicedth]ik/ adj. os·te·o·path·i·cal·ly / ˌästēəˈpa[unvoicedth]ik(ə)lē/ adv.

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"osteopathy." The Oxford Pocket Dictionary of Current English. 2009. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

"osteopathy." The Oxford Pocket Dictionary of Current English. 2009. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1O999-osteopathy.html

"osteopathy." The Oxford Pocket Dictionary of Current English. 2009. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O999-osteopathy.html

osteopathy

osteopathy (osti-op-ă-thi) n. a system of diagnosis and treatment based on the theory that many diseases are associated with disorders of the musculoskeletal system. Diagnosis and treatment of these disorders involves palpation, manipulation, and massage. Osteopathy provides relief for many disorders of bones and joints.
osteopath (ost-i-ŏ-path) n. —osteopathic (osti-ŏ-path-ik) adj.

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"osteopathy." A Dictionary of Nursing. 2008. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

"osteopathy." A Dictionary of Nursing. 2008. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1O62-osteopathy.html

"osteopathy." A Dictionary of Nursing. 2008. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O62-osteopathy.html

osteopathy

osteopathy System of alternative medical treatment based on the use of physical manipulation of joints to rectify damage caused by mechanical stresses. US physician Andrew Still founded osteopathy in 1874.

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"osteopathy." World Encyclopedia. 2005. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

"osteopathy." World Encyclopedia. 2005. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1O142-osteopathy.html

"osteopathy." World Encyclopedia. 2005. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O142-osteopathy.html

osteopathy

osteopathy •Cathy •Iolanthe, Xanthe •McCarthy • breathy •healthy, stealthy, wealthy •lengthy •heathy, Lethe •pithy • filthy •bothy, frothy, mothy, wrathy •toothy •polymathy, timothy •apathy • telepathy • empathy •antipathy • sympathy •encephalopathy, homeopathy, osteopathy •Dorothy • earthy

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"osteopathy." Oxford Dictionary of Rhymes. 2007. Encyclopedia.com. 30 Jul. 2016 <http://www.encyclopedia.com>.

"osteopathy." Oxford Dictionary of Rhymes. 2007. Encyclopedia.com. (July 30, 2016). http://www.encyclopedia.com/doc/1O233-osteopathy.html

"osteopathy." Oxford Dictionary of Rhymes. 2007. Retrieved July 30, 2016 from Encyclopedia.com: http://www.encyclopedia.com/doc/1O233-osteopathy.html

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