Osteopathic manipulative medicine

Osteopathy is a type of alternative medicine that emphasizes physical manipulation of muscle tissue and bones. Practitioners of osteopathy are referred to as osteopaths. Its name derives from Ancient Greek 'bone' (ὀστέον) and 'sensitive to' or 'responding to' (-πάθεια). The UK's National Health Service says there is 'limited evidence' that osteopathy 'may be effective for some types of neck, shoulder or lower limb pain and recovery after hip or knee operations', but that there is no evidence that osteopathy is effective as a treatment for health conditions unrelated to the bones and muscles. Others have concluded that there is insufficient evidence to suggest efficacy for osteopathic style manipulation in treating musculoskeletal pain. Osteopathic manipulation is the core set of techniques in osteopathy and osteopathic medicine. Parts of osteopathy, such as cranial therapy, have no therapeutic value and have been labeled as pseudoscience. The techniques are based on an ideology created by Andrew Taylor Still (1828–1917) which posits the existence of a 'myofascial continuity' – a tissue layer that 'links every part of the body with every other part'. Osteopaths attempt to diagnose and treat what was originally called 'the osteopathic lesion', but which is now named 'somatic dysfunction', by manipulating a person's bones and muscles. OMT techniques are most commonly used to treat back pain and other musculoskeletal issues. In the United States, the training of osteopathic physicians (who practice osteopathic medicine) has become substantially similar to that of regular physicians. While osteopathic manipulation is still included in the curricula of osteopathic physicians, and is promoted as a unique aspect of DO training, this has been described as nothing more than ''extra' training in pseudoscientific practices'. Osteopathic medical schools also tend to be weaker than MD schools with regards to research and the understanding of scientific inquiry. In other countries, training may focus primarily on osteopathy and does not include a standard medical education, with graduates being referred to as ' osteopaths'. The government policy and legal framework in which practitioners operate vary greatly from country to country. Osteopathic medicine was founded by Andrew Taylor Still, a 19th-century American physician, Civil War surgeon, and Kansas state and territorial legislator. He lived near Baldwin City, Kansas at the time of the American Civil War and it was there that he founded the practice of osteopathy. Still claimed that human illness was rooted in problems with the musculoskeletal system, and that osteopathic manipulations could solve these problems by harnessing the body's own self-repairing potential. Still's patients were forbidden from treatment by conventional medicine, as well as from other practices such as drinking alcohol. These practices derive from the belief, common in the early 19th century among proponents of alternative medicine (then called 'irregular medicine' or 'unorthodox medicine'), that the body's natural state tends toward health and inherently contains the capacity to battle any illness. This was opposed to orthodox practitioners, who held that intervention by the physician was necessary to restore health in the patient. At the time Still established the basis for osteopathy, the division between irregular medicine and regular medicine had already been a major conflict for decades. The foundations of this divergence may be traced back to the mid-18th century, when advances in physiology began to localize the causes and nature of diseases to specific organs and tissues. Doctors began shifting their focus from the patient to the internal state of the body, resulting in an issue labeled as the problem of the 'vanishing patient'. A stronger movement towards experimental and scientific medicine was then developed. In the perspective of the unorthodox physicians, the sympathy and holism that were integral to medicine in the past were left behind. Heroic medicine became the convention for treating patients, with aggressive practices like bloodletting and prescribing chemicals such as mercury, becoming the forefront in therapeutics. Alternative medicine had its beginnings in the early 19th century, when gentler practices in comparison to heroic medicine began to emerge. Homeopaths, Thomsonians, and hydropaths practiced unconventional forms of healing that may have had strong appeal to patients due to their more attenuated practices. As alternative medicine grew to include more followers, orthodox medicine continued to rebuke and seek to invalidate the 'irregulars,' as termed by the orthodox practitioners in heroic medicine. As each side sought to defend its practice, a schism began to present itself in the medical marketplace, with both the irregular and regular practitioners attempting to discredit the other. The irregulars — those who are now referred to as Alternative Medicine practitioners — argued that the regulars practiced an overly mechanistic approach to treating patients, treated the symptoms of disease instead of the original causes, and were blind to the harm they were causing their patients. Regular practitioners had a similar argument, labeling unorthodox medicine as unfounded, passive, and dangerous to a disease-afflicted patient. This is the medical environment that pervaded throughout the 19th century, and this is the setting that Still entered when he began developing his idea of osteopathy. After experiencing the loss of his wife and three daughters to spinal meningitis and noting that the current orthodox medical system could not save them, Still may have been prompted to shape his reformist attitudes towards conventional medicine. Still set out to reform the orthodox medical scene and establish a practice that did not so readily resort to drugs, purgatives, and harshly invasive therapeutics to treat a person suffering from ailment, similar to the mindset of the irregulars in the early 19th century. Thought to have been influenced by spiritualist figures such as Andrew Jackson Davis and ideas of magnetic and electrical healing, Still began practicing manipulative procedures that were intended to restore harmony in the body. Over the course of the next twenty five years, Still attracted support for his medical philosophy that disapproved of orthodox medicine, and shaped his philosophy for osteopathy. Components of this philosophy included the idea that structure and function are interrelated and the importance of each piece of the body in the harmonious function of its whole. Still sought to establish a new medical school that could produce physicians trained under this philosophy, and be prepared to compete against the orthodox, or allopathic, physicians. He established the American School of Osteopathy on 20 May 1892, in Kirksville, Missouri, with twenty-one students in the first class. Still described the foundations of osteopathy in his book 'The Philosophy and Mechanical Principles of Osteopathy' in 1892. He named his new school of medicine 'osteopathy', reasoning that 'the bone, osteon, was the starting point from which was to ascertain the cause of pathological conditions'. He would eventually claim that he could 'shake a child and stop scarlet fever, croup, diphtheria, and cure whooping cough in three days by a wring of its neck.'