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Metaphysical Medicine The Rise and Fall of a Medical Reformation: From Physicians to Technicians by Walter Llewellyn McKone D.O. www.osteopathicphilosophy.com mckone@osteopathicphilosophy.com |
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Comme quelqu’un pourrait dire de moi que j’ai seulement fait ici un amas de fleurs etrangeres, n’y ayant fourni du mein que le filet a les lier. And one might therefore say of me that [in this book] I have only made up a bunch of other people’s flowers, and that of my own I have only provided the string that ties them together. Michel Eyquem Montaigne, 1533-1592 |
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| AN INTRODUCTION Sunday 16 March 2003, just after 9pm. It’s been a fabulous weekend, the sun’s been shining and our friends from St Helens have left. Max and Oskar, my seven and two-and-half year olds, respectively, are asleep. My partner Katharina has gone out to see friends. Once again this book has come into mind. How am I to write this work? What style should I use? Importantly I want anybody and everybody to read what I have discovered. Why not just write as I am thinking? Take a break with the academic style and make it personal. With what I have to say I may end up as Billy-no-mates or in this case Wally-no-mates. As an osteopath who has been in practice for twenty years I have had a varied and exciting career. Over this time something had been bothering me and I think I have found what it is. Increasingly over this period patients and their ailments I have been treating have changed. Out is the dominant complaint of back pain and tennis elbow, although I still see these problems, more popular are the diseases of modern living, breathing problems, eczema, digestive disturbances, anxiety etc. It all began about ten years ago when I had finished a life of sports medicine that took to the heights of American football in the United States and Europe. Settling down into private practice I was unaware of the skills I had acquired in a field of trauma and infection that demanded a quick outcome. Speed of treatment was important, as the players wanted to be better by Saturday. I now know this to be a “find it, fix it, leave it alone” approach, which will be explained. Three maybe four treatments a day for muscle and joint injuries had some strange side effects. Other conditions that “weren’t important at the time” began to heal quickly. Sore throats, wound infections and stomach problems, to name a few, also settled down. These manipulative skills were not the same methods I was taught as a student. They were more a “treat-as-you-find” approach, letting the tone of the tissue local and general dictate my actions. With the calm and time of private practice patients started informing me of other conditions that “went away” after the treatment of seemingly distant and unconnected complaints. In 1997 I published my first book Osteopathic Athletic Health Care: Principles and Practice based on my experience in American football. Trying to piece together an approach for this desired accidental outcome. In true academic style I began my research to find connections between parts of the body and my treatment that would begin to explain these changes. And the reviews for my work were encouraging from osteopaths around the world who had experienced similar responses with their patients. Could I go any further? Perhaps I could move into the world of the general public. My research continued by trawling the archives of osteopathic literature in the library of the British School of Osteopathy, London. Why were these nineteenth and early twentieth century books claiming to treat dysentery, typhoid, malaria, influenza and in some cases “tumours?” Why were these books not used any more? And in particular why was I not taught how to treat these conditions? Inquiring amongst older colleagues in my profession led in the main to an immediate dismissing of such “old-fashioned” works of medicine. I was still uncomfortable with their easy and quick answers. And as I have since found out the majority of these practitioners haven’t even read the works, and those that have didn’t understand them. Reading these early works made me uneasy, as it was going against my training. I have since realised that this was because there is very little or no mention of the conditions that the modern hands-on osteopath treats. These conditions are back pain, tennis elbow, stiff necks, weak ankles, in fact nearly all the muscle and joint complaints that I was taught to treat. One early work mentions back pain in the appendix taking up about four lines. How could the early osteopaths have survived if they did not treat these conditions? More questions kept coming. Further research led to the publication of my second work Osteopathic Medicine – Philosophy, Principles and Practice. Again this was an attempt to piece together old works and new research. Again a pattern was forming and as before it was incomplete. This book brought a more contextual approach. What was the environment in which osteopathy began to develop? What were the socio-political circumstances? And the main question, What was the philosophy? |
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| OSTEOPATHY Andrew Taylor Still, MD, (1828-1917) was a medical doctor and the founder of osteopathy. He formed his ideas about a “reformation of the then system of surgery and medicine” after his experience in the American Civil War and on returning home the terrible experience of the death of his children to spinal meningitis. You can’t suddenly come up with an idea like this out of the blue. Especially one that “cures” major diseases without the dependence on medication. Modern osteopaths have it wrong, very very wrong for the following reasons. Osteopathy used to be based on a surgical approach today, it is based on a medical model. Osteopaths of old used to be called “bloodless surgeons” and “fever fighters.” Since there were no antibiotics a way had to be found to enhance the healing capacity and reduce the temperature of the body. As a full system of “bloodless surgery”, the word surgery means handcraft, infections had nowhere to go. Early works make little reference to the muscle and joint system, what they did call osteopathy was a “system of natural immunity.” This approach was not anti-viral or anti-biotic it was pro-health towards the entire body. “It should be remembered that at about the time that Dr. Still developed and announced his theory of Natural Immunity Lister was developing the first methods of antisepsis and Koch was identifying the first known specific disease producing organisms such as those of tuberculosis, typhoid, tetanus and diphtheria. Dr. Still was a pioneer in his own right and gave to the world a theory of immunity a half a century in advance of his time.” Foreword by Committee of Publication of the Academy of Applied Osteopathy, January 15, 1946. In Philosophy of Osteopathy (by Andrew T. Still, 1899). How could he have performed such “miracles” without the knowledge we have today of bacteria, viruses and pharmacology (drugs)? The answer was out in the open. As a “professional” I was trained to order, categorise, exclude and reduce everything to simple easy procedures. Dr Still’s writings were vague, wishy-washy and there was no formula to treatment. Any wonder everybody was calling it old. Some even called it poetic and quaint. What was even stranger was that Dr. Still wrote that, “osteopathy is a philosophy,” no mention of treatment. Not being a philosopher I naturally over looked this statement as poetic licence. It was not until a year after my second book had been published that an interested party, who had read my work, e-mailed me the title of a book that may be of interest. In this book I stumbled upon the following quote, I have highlighted the important parts that I will explain: “They (osteopathy, surgery and dentistry) are directly related to those mental operations which are developed in the philosophy of Phenomenology, itself a post-Cartesian outlook. Relating this method to current philosophy of science, it cannot be judged in any way less powerful than Cartesian science, for while the latter has no verification procedure, relying upon falsification alone, Goethean science entails both falsification and verification, and thus might even be said to be more complete than Cartesian. Again, the only real problem with the approach the author sees is the fact that very few know of its existence.” Towards a Man-Centered Medical Science. Forward by Rene Dubos, The Rockefeller University, New York, New York. 1977. To say I was confused was an understatement. I had already mentioned Johann Wolfgang von Goethe, hence Goethean, in my last book and had wished to find something of a more concrete nature, and here it was. I was well aware of Goethe, as my partner Katharina is from former Eastern Germany and was born in Weimar, Goethe’s hometown. Don’t panic. Now for the brief explanation: Mental operations – means the thinking of the osteopath, surgeon and dentist. These practitioners work “at the coal face” of human anatomy. Human anatomy is a natural phenomenon and no two patients are the same. It is the way that the practitioners think (mental operations) while they are directly treating your tissues and taking into account the differences from person to person, this is what makes them effective. Human anatomy is a natural phenomenon and the study of the relationship between natural phenomena and the person in its presence is known as phenomenology. Phenomenology – this is a philosophy attributed to Edmund Husserl (1859-1938) and was developed as “the foundational science of all sciences, as a revival of ‘first philosophy’ and as a radical transcendental idealism.” And it is intended as “a presuppositionless science which seeks to bring intuition the essences of thought and knowledge in their most complete generality, through exploring the analytic connections between meaning intentions and meaning fulfilments in a way that rigorously avoids psychologism (Moran and Mooney, 2002).” In a nut shell this is the place to start all scientific approaches in an unbiased way in which the scientists has to pay attention to how the science is to be performed. In addition the experience is direct. The surgeon directly treats you unlike medicine where you are treated at a distance. You are prescribed medication and your doctor does not see you take it. That’s second hand treatment. Post-Cartesian outlook – Cartesian comes from the name of a famous philosopher priest René Descartes (1596-1650). Amongst a few others he was accredited with officially naming mind and body as separate things. Descartes lived during the 17th century and phenomenology was developed at the end of the 19th century. This makes it after Descartes, that is a post-Cartesian outlook or way of seeing. Cartesian science – Because Descartes said the body was a machine he used mathematics to mechanise everything and began the geometrical and mathematical view of nature, hence Cartesian geometry. He called this a natural science, this is how we do science today. That’s why it is known as Cartesian science. No verification procedure, relying on falsification alone – you cannot prove, verify, anything in today’s style of science as something comes along and changes your interpretation and places doubt within your findings, for good or bad. Of paramount importance I will repeat that I am concerned with the organism living organisms. This is why one minute it is all right to eat eggs and the next moment it isn’t. If you think you’re confused imagine how the scientists feel. In fact they are not confused as the majority, as with fundamentalist religion, stick to their scientific method till the end. In the words of the physicists Steve Adams, “The fundamental nature of scientific theory is that it can only be refuted, never proven.” Things within a modern Cartesian objective science can only be proven wrong or falsified. On 17 May 2003 the British Medical Journal published a paper, Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98, by Enstrom, J. E. and Kabat, G. C. “The results do not support a causal relation between environmental tobacco smoke and tobacco related mortality, although they do not rule out a small effect. The association between exposure to environmental tobacco smoke and coronary heart disease and lung cancer may be considerably weaker than generally believed.” This paper would have had to be peer reviewed, meaning that a panel of eminent scientists would have had to look at the work before publication to see if it conformed to what is regarded as scientific methodology. Critics started shouting about the fact that the tobacco companies sponsored the research. I think they need reminding that the tobacco companies are drugs companies. All drugs companies, including the tobacco companies, have to answer to their shareholders not the public. Neither the tobacco or regular drugs companies are interested in killing nor healing the public as a priority, their priority is maximising profit, not human welfare or destruction. The key issue here is not whether the research was right or not, although at this point I would say it was right by conforming to a scientific methodology, but the fact that by using a correct methodology you can come up with a socially undesirable conclusion. Additionally, it goes to show that the values and meaning placed held by the scientists and sponsors affect the outcome, no matter how rigorous the science is. No experiments are objective and value free. Think about it next time a famous drug company proves something about our health. Goethean science entails both falsification and verification – the science of Johann Wolfgang von Goethe is the only natural science in the Western world it treats both observer and that observed as continuity. Imagination and intuition are held within the scientist. To give an example I will make a comparison with how we already practice. Here is an example: A physician encounters 100 patients with broken legs. In a Cartesian science the criteria of observations made by the physician are gathered for further reference. This is generally achieved by documenting the common signs and symptoms. Consequently other physicians can read the information and when they see a broken leg they can recognise the presentation. Nothing wrong with this, but it a dominant way of educating and training out physicians. In a Goethian science the physician experiences intentionally the 100 patients with broken legs. He or she has been trained in sensorial-imagination and phenomenology as a scientific methodology (all will be explained). What is gathered from these experiences is transferred to patient 101. It is a physician-centered science and brings into play all the values and meaning at that time and place. This is opposed to Isaac Newton’s mechanical science that followed on from René Descartes. Goethean science involves the scientist, their thoughts and actions as a total activity. Cartesian-Newtonian science relies on the process and the result is an objective-subjective (mindless and mindful) separation science. In Goethean science the presence of the scientist affects the outcome and is subject to the values and meaning held by the scientist. Values and historical-cultural meaning can change and therefore this approach relies on the scientist and is not mathematical process dominated. So Goethean proof or verification involves the judgement of the scientists and their historical-social-cultural values built into the system. This is why it cannot be disproved! A further example of differences between the Newtonian and the Goethian approach is found in the issue of the source of colour. Newton has us all believing that colour is from the breakdown of white light but this is because of his agenda at the time. As Bortoft (1996) wrote, “Goethe’s concern with colour arose out of his interest in art (Newton’s arose out of his technical interest in improving telescope images).” Therefore the whole issue was around the lens capability and refraction of light. But Newton did concern himself with the subjective nature of the observer. His supporters ignored his comments, as it was not the kind of science they wanted put about (Goethe, 1810). More complete than the Cartesian – because the Goethean has the scientists’ values and meaning built into the system it is an ongoing first hand experience on the part of the practitioner (scientist) in participation with the patient. A Cartesian approach attempts to separate the practitioner and the patient at all times, and is therefore liable to misinterpretation and a greater number of mistakes. With separation comes a step-wise process which is all very well when inventing computers but is extremely weak when dealing with human beings. The Goethean science is therefore more complete than the Cartesian. Modern osteopathy no longer uses its Goethean philosophy so today it is a philosophical orphan, dragged around from country to country being suffocated under a modern Cartesian way of seeing the world. |
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| SIZE SEEMS TO BE EVERYTHING People mistakenly blame science for the insensitive way the Western world investigates nature. What we call science in everyday language is only as style of science. The word science originates from the word scientia mistakenly translated as, to know. What it actually means is to come into knowing, changing the way of knowing as an ongoing movement, with nature. “To know” leads to what we today interpret as a fact. This is an end of line stopping knowledge. Each of these facts we than string together and like the single scenes of a movie we run the film giving the impression of a moving scene. No matter how fast you run the film this cinemagraphic approach of single scenes does not change, it has gaps, no matter how fast (or advanced) it moves. And if you want to take it further then we can look at the development of digital film and radio. These are even more highly developed sequences of isolated information played in sequence. This is a fabulous achievement and I’ve just bought a DVD player, marvellous. A science that leads to this technological “advance” is one of breaking up the material of the world into small packages, and using symbols, numbers and letters, to reconstruct the matter in a synthetic organised form. In fact it is matter and material change that was the result of previously held values, “an advance”. Why do we do this? Simply, because we already see the world in this way. We are only capable of moving through the world with the thoughts we already posses behind our eyes, ears and other senses recognised by Thomas Huxley. As a consequence we are mistaking science for technology, the measurement and manipulation of matter. Modern medicine is being overwhelmed by a mathematical technological mentality. In the world of philosophy this approach is known as quantitative, objective, atomistic, symbolic and reductionist amongst other terms. A quantitative approach means we use symbols and measure the world and this we believe to be the true world. That which cannot be measured is irrelevant. The only problem is that we set the measurement and then the rest of the world has to try and fit into this way of understanding, otherwise we ignore it or rather don’t see it. Objectivity is something we are very proud of. We like to think that to be objective means that we were able to experiment on something, anything, and not interfere with the results of our experiment. In other words we pretend we are not there. If you think that is worrying, the actual word objectivity means mindless. So we are mindless while performing scientific experiments! As absurd as that may seem this is actually what modern science is trying to achieve this is why numbers and language are so important. Do you remember at school having to write up your physics or chemistry experiments? It had to be written in the third person. “A test-tube was taken and to this test-tube was administered 2 mg of X and a further 5 ml of Y etc etc.” as though you weren’t there. “The scientific method is, in a sense, the great democratizer of knowledge. It is a recipe for knowledge. Given a problem, the scientific method gives a set of rules for solving it, and a very clear set of criteria for deciding when, in fact, the problem is solved. In a sense, it makes the criterion of knowledge accessible to anyone. Just follow these rules, and you will get your answer. Science, from this point of view, is a way of knowing for those who are not very smart. It is so powerful that you don’t have to think too much about what you’re doing to get the right answer. But, indeed it is a powerful method.” John Vandermeer, Reconstructing Biology: Genetics and Ecology in the New World Order. 1996. All scientific activities are meaning and value dependent. Just choose your meaning and values. Objectivity is useful and it is doing pretty well; we will look at the reason for this later. Reductionist objective science is trying to remove the human thought or consciousness from the experiment and experience. Ultimately the goal of modern science is to get rid of the human all together. How far can the desire for objectivity lead us? Mary Midgley, one of my favourite philosophers, wrote in 2001, ‘The behaviourist psychologist John B. Watson advised parents, in a widely read psychological handbook of the 1930s, not to hug or kiss their children because such conduct was not ‘objective’, and speculated that it would be ‘more scientific’ not to allow parents – who were clearly prone to this behaviour – to bring up their own children.’ All around us we are substituting and amplifying the quantifiable human characteristics as if size were everything, a typical male response. We can engineer the biggest cruise ships, faster planes and the smallest telephones. This method of science is following a religious hidden agenda that is based on seeing the world in order and the control of nature. Reasons for this is connected to the Original Sin of religion as humans are unworthy and God likes order. Since God is up then the mechanism for the “working” on the physical world must be down. We trust the tests, experiments and machines made by the hand and mind, but we do not trust the hand and mind that made the tests, experiments and machines. |
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| OUR DEAD WORLD Modern medicine interprets the body as a machine and sees anything less than health a dead or potentially dead state. Exercise is a good example. Exercisim has its roots in Exorcism: both originate from a need “to workout” badness or evil spirits. (We shall be looking at this in more depth as the Non-Cartesian Athlete.) Since God is perfection (the spiritual side of the Cartesian coin) then the athlete is perfect, as a machine (the mechanical side of the Cartesian coin) and everybody else is somewhere between this and death. The patient is a Cartesian corpse in a Korpenswelt, or dead world where as the original osteopathy was in a Leibenswelt or living world, as a total person, with values, emotion and meaning. Even today in its country of origin, the United States of America, the majority of osteopathic practitioners are both embarrassed by osteopathic medicine’s historical claims and at the same time they are trying to keep it as a separate profession to regular medicine. In the US osteopaths practice medicine and surgery as freely as your regular doctors do. Work that one out! We see the world as dead because we have a dead or depressed way of seeing the world. Let’s take gravity for example. “Now there’s no way you are going to tell me that gravity doesn’t exist?” You are probable thinking. Due our reductionist way of seeing a modern definition of gravity is something like this - It is the force originating from the non-equilibrium of charge on the left and right of the particle and the resulting flow out of it. Have a look out in the open, what do you see? Trees, birds, houses, cars, airplanes, sheep, whatever. How many of the living things are falling down out of control? Living organisms express themselves into their environments, they are not fall down. Cars, houses and airplanes have to be designed with gravity in mind, as they are dead. Gravity only exists as a dominant medium for the dead or dying organisms and inorganic matter. Sir Isaac Newton brought gravity to our attention; he was a chronic depressive. For the living it is known a levity the polar energy to gravity, if you really want to know. I had a lot of questions that needed answering. How could osteopaths have treated, successfully, diseases such as influenza? What was the early osteopathic philosophy? Why has osteopathy changed so much in over 100 years? And why are osteopaths treating fewer conditions? |
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| THE ORIGINAL APPROACH November 2001 Milan, Italy, I was asked to give a three-day presentation on osteopathic sports medicine. Day one was generally about the philosophy and moved on to some basic aspects of an osteopathic approach to sports medicine as opposed to a medical approach. Day two moved towards principles of practice, prevention of trauma (injuries and environment), training techniques, and the development of palpation (touching) skills. Day three was something that I had not experienced before. After day two we went on the usual food/drink fest that my Italian guests knew I would enjoy. It seemed that every one of the thirty or so delegates had a relation who owned a restaurant. That night, or was it early morning, in the hotel I picked up my book on Osteopathic Medicine and started to flick through it. Unusual as it may seem the research I had put into the book I hadn’t really put to any real practice. I had prepared my lecture for the next day, the usual mindless manipulative techniques, but now it was all going to change. On day three I completely changed the programme. Instead of the joint and muscle manipulation techniques I was, for the first time, going to demonstrate the original manipulative approach of osteopathy. And what is more I wanted all the delegates to be able to do the same by the end of the day. To be honest I didn’t know if it was going to work and if it did how well it would work. I needn’t have worried, it turned out better than my wildest dreams. What was it I was going to show them? As I have said osteopathy or osteopathic medicine was about the immune system or natural immunity. It could boost your immune system or decrease your recovery time from a general infection. To achieve this you have to control the circulation of blood and a fluid called lymph that has its own vessels just like blood vessels that form a network throughout the body. Lymph is a fluid that contains proteins, fats and white cells that fight infections. I was going to demonstrate the Primal approach of osteopathy as a control of the pulse rate which would be raised during an infection. In the workshop I dropped and increased the pulse rate at will of my student who volunteered as a model. By the end of the day all the delegates were not only controlling the pulse rates but they were directing circulation to certain parts of the body. Bringing blood to areas and drawing blood from areas literally at will. The key to good health is a combination of breathing and circulation. April 2003 Bilbao, Spain, I was invited to give a presentation over the two days of a weekend on osteopathic sports medicine as I was in Milan. This time I knew what I was going to do but I had less time in which to do it. Problems began by the first break of the first morning. I was informed that the delegates only wanted the usual push-pull mindless manipulation techniques. You know the stuff, click-crunch and lots of massage dressed up as some sort of highly skilled activity. I still managed to get my circulation demonstration and workshop across by the second day but it wasn’t going anywhere as they wanted click-crunch. So, I gave them click-crunch and they were all happy. Both groups had problems understanding that they now had the power to control the temperature, pulse rate and blood pressure of the body preventing or delaying a body crisis. What could the possibilities be if you could control these factors as well as click-crunch the body? The story is told of Thomas Edison, that when he was demonstrating his new invention of the light bulb. A woman from the audience commented, “Mr Edison, what use is this light bulb?” and Edison replied, “what use is a baby madam?” Demonstrating this manipulative approach without understanding is just mimicking; it’s a bit like starting with the answer and formulating questions. All osteopathic manipulation is basically mimicking and imitating the demonstrator. So the real desire in many osteopaths is to be a master technician in the hope that they will be able to treat anything. Technicians are technicians they are not physicians. Osteopaths used to be physicians that’s why they used to treat diseases, now manipulation is only good for dysfunctions, sprained ankles and bad backs. A biophobia, biological or nature fear, seems to dominate our lives including those of osteopaths. As human beings we are nature. In fact you could say that we fear looking nature directly in the “I”. We continue to practise and maintain an active process of mental disconnection with our environment so well that we are unaware that we are doing the separation to our world. Obviously we are not disconnected. This disconnection has taken place as an active learned process from childhood. We maintain and impose an order on our world as a constant activity. David Bohm’s work Wholeness and the Implicate Order is a good introduction to this approach. |
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| THE METAPHYSICAL MEDICINE This book is about the reclamation of an idea, an idea that has suffered discontinuity and therefore has gone through a regression from which it has not recovered. Modern Western culture has moved with such speed in the last one hundred years with the surge in industrialisation, media, and energy resources that we have forgotten the fundamental Ideas of these beginnings. We live in an impatient, stimulatory, materialistic hyperculture. No longer do we include, as our main source of understanding, the teachings of styles of thinking that reflected on the past and helping us to reason and make dynamic decisions about the future. Our needs are dominated for what is “relevant” and little else. This relevance is a present day culture laden situation suffering from short sightedness that we are either conditioned to or we ignore, allowing ourselves to stumble thorough life hoping, just like a lottery, that if we keep going we will draw a lucky number and be able to step out of mainstream society. The present day practices of health sciences are a major contradiction in terms. Even the word Nature has been replaced by a number of more technologically comfortable words, for example, biodiversity. Our health sciences are driven by the Cartesian way of seeing and doing, killing our very planet. Many scientists try to redress the balance by proposing a new more Nature friendly approach. Attempts to piece together the world are in vain as the world is not in pieces in the first place. The only problem is that they are still using the Cartesian approach, which is an inherently unhealthy way of seeing the world around us. What we need is not a new health science but a healthy science in which to begin to look at health and disease. Osteopathy was based on a healthy science now it is based on a health science. Osteopathy is a first hand experience medicine. Dr. Still called it a combination of “Mind, Matter and Motion”. Dr. Andrew Taylor Still was the first to put this in practice in modern times. Why is the osteopathic profession so embarrassed about its heritage? Osteopathy is a philosophy in action. Osteopaths are physicians, in the true meaning, to return to normal, they have become slaves to manipulation and are now technicians. As is the case when trying to change the minds of those who earn a living by what they do I get ignored or at best tolerated. After the research of the past five years I think I have found a workable Idea as to how these “miracles” were performed. And as is the case with all magic, once you know how the trick is done it’s very simple. As my friend Henri Bortoft said, “It seems clever that somebody can pull a rabbit out of a hat, but somebody had to put it there in the first place.” I have found the philosophy that formed and provided the power of original osteopathic thought with its roots in the works of Goethe, it is called Pragmatism. Charles Sanders Peirce first used the word pragmatism, in 1878, to designate a principle put forward by him as a rule for guiding the scientist and the mathematician. The principle is that the meaning of any conception in the mind is the practical effect it will have in action. The rule remained unnoticed for twenty years, until Professor William James used the term at the University of California in 1898. Since osteopathy’s development of pragmatism the additional approaches of Phenomenology and Hermeneutics bring it into the twentieth century. (Don’t worry about these words, all will be revealed.) Without these systems of thought and seeing the world there is no mindfulness about how to begin to treat an ill patient. It is for the public to understand, as the modern osteopaths are too busy. My wish is that the public change osteopathy once and for all. Returning it to its original approach by demanding their infections be treated without the dominant use of medication. And conditions that would normally need surgical intervention are looked at with another idea in mind. I need the public to change osteopathy for the sake of the public’s physical and mental health. It does not change what is being taught or practised as osteopathy but it will give osteopathy the ability to move on. Keeping with an approach of contextuality the book will begin with the inherently boring beginning of the modern scientific movement in and around the seventeenth century. Inherently boring because I have yet to find any work that doesn’t make you want to take your own life after a few pages. This in itself was a challenge and I was not surprised that very few people, in the real world, have read about such an important period in European history. Philosophers around this time were not the same as they are today. They were philosopher somethings. Philosopher-physicians, philosopher-astronomers, philosopher-geologists in fact they were natural philosophers not scientists in the modern way. Today philosophers tend to be bound to language and perception as if the secret of knowledge and consciousness is hidden in the words. Just because I think in words does not mean that words are the foundation of my state of thinking. From this point scientists jump to the brain as the central organ of thinking and may even bring to attention the unit of thinking, the nerve or neurone. Today’s philosophers are reductionist and promote separateness as much as the scientists that tend to ignore them. Without doubt René Descartes, hence the word Cartesian, was the most influential philosopher in European history and we would not be where we are today without him. But there were others who disagreed with this idea. At this point it is easy to run off a list of philosophers' dates and influences. This method is one of the reasons most people don’t read philosophy. But there were a few around the time that warrant a mention, especially Baruch Spinoza. Staying with this theme of separateness I will look at the place of mathematics as an instrument of division and attraction as God’s chosen method of order over Nature and the universe. Trying not to lose the plot and keeping it relevant to the idea of the book, I want to emphasise that any symbolic representation leads to a second hand way of thinking. This second hand way of thinking disempowers the scientist placing him or her in a quantitative billiard-ball, cause and effect, way of seeing the natural world. Don’t get me wrong: I have no problem with the billiard-ball way of seeing the world when I want somebody to build me a house or a new car. But this approach is a little weak and ridiculous when applied to a sore throat or any infection. Books are flooding onto the market attempting to redress this balance. Unfortunately they are riddled with Cartesian language and metaphors that weaken the over all understanding of the natural world. Words such as data, processing, computer, wheels, input, and output are demonstrating an underlying mechanical cogwheel philosophy and mentality. Moving along gently I will introduce the reader to the development of holistic and organic scientific ideas. Placing the scientist at the centre of the phenomenon of health care by way of sense and reason, I will show how this non-mathematical approach is just as hard to learn, as are the modern methods of research and inquiry. Here the emphasis shifts from the process and theory laden approach of modern science to the phenomenon and participation approach by the physician. How do these ideas lead to this approach and the context under which it literally makes sense to the scientist? Having set the scene from the scientific-philosophical perspective from Europe we move towards the United States of America in and around the mid-1800s. During this period there continued an increasing movement of German immigrants. For many reasons they moved on to a new life bringing with them their culture and most importantly, their philosophy and thinkers. One of the many thinkers whose ideas were brought across the water from Germany to the USA was that of Johann Wolfgang von Goethe. In addition many settled German-Americans went home to visit the old country and even those who were not from the old country saw Germany as a source of further study in the areas of psychology, philosophy and medicine. In particular William James spent one particular summer in Germany reading Goethe only to return a few years later and become involved with the Pragmatism movement and the Metaphysical Club. Major changes in this philosophical approach took place seemingly as a result of experiences during and after the American Civil War. Social and political movements amplified the already expanding changes in agriculture and industry. Economics and investment reflected a strengthening country. One of the many problems at the end of the nineteenth and beginning of the twentieth century was the increasing demand for medications with a cocaine basis, hence coke-a-cola. After the Civil War the pharmaceutical industry was one of the few areas of safe and profitable investment. Osteopathy, “bloodless surgery” and “fever fighting,” was born out of the War and the ideas of the founder Dr. Still. This idea of direct involvement was the result of the gymnastik approach of the German culture with its liberal ideas. Osteopathy was a liberal and gentle approach to the body. In 1919 Ernest Tucker, DO wrote in the Journal of the American Osteopathic Association about the real Dr Andrew Taylor Still. The paper was titled Dr. Still, the Metaphysician. Tucker called… “Dr. Still a great metaphysical mind. To understand the faculty that produced osteopathy is to re-discover it at its original sources, and to open the way to endless further discoveries of the same kind. That faculty was a great metaphysical faculty, and osteopathy is a great triumph of metaphysics.” Comparing the work of Immanuel Kant, especially the Critique of Pure Reason, with the idea of osteopathy, he showed that osteopathy’s underlying philosophy was that of the science of the living organism not the scientific mathematical dominant system of today. Both osteopathy and mathematics are the results of a metaphysical approach towards the world. Don’t let this book title put you off. Metaphysics is not that complicated. Academics make it complicated it keeps them in work. In fact it’s so simple that you are going through a metaphysical experience as you read these words. The Metaphysical Medicine should make you more comfortable and more empowered. It should allow you to understand many emotional and physical problems that you have been asking questions about. Will this book give the answer? No. But it will empower you with the basis to work out your own answer. Something that modern medicine has taken away from the individual. Metaphysics is that part of philosophy that tries to understand the basic nature of our world, including what you see and what you feel. It seeks a description so basic that it applies to everything, whether divine or human or anything else. It attempts to tell what anything must be like in order to be at all. Don’t be scared. As to philosophy it has been translated into “love of wisdom,” nothing more nothing less. Unfortunately today’s style of philosophy has a little too much of a hidden agenda, as we shall see. And there was no original mention about being smart and coming up with an answer. Yes, I’m going to keep it simple, not simplistic. Too many popularisations are still too “clever.” This is for everyone. Simple because I will take you through this work while building an Idea or way of thinking when faced with any situation. As opposed to simplistic which breaks an Idea down, for example, making two dots and drawing a straight line connecting the dots and building everything up from this method. As we shall see this has already been done. So-called popular science books are still full of jargon. And they can still run into well over three hundred pages, what’s that all about? I suppose it is a demonstration that they know what they are talking about. That reminds me of Walter Kaufmann from Critique of Religion and Philosophy, “Whatever professors of philosophy take up nowadays tends to become scholastic, and the rigor of the scholastics is rigor mortis. Goethe’s Mephistopheles urged the student who sought advice about courses “to start with Logic”: For thus your mind is trained and braced, In Spanish boots it will be laced, That on the road of thought maybe It hence creep more thoughtfully… Who would study and describe the living, starts By driving the spirit out of the parts: In the palm of his hand he holds all the sections, Lacks nothing, except the spirit’s connections. Scholasticism has not changed its ways. Rigor sets in after the life has been driven out of the parts. To creep is a virtue, to leap a vice, and speed the sin of the spirit.” If you know what you are writing about, why should it take so long? What’s your point? Whether the scientists of today like it or not the everyday person’s view of the world is changing. Changing as a result of constant questioning and the result of bringing their personal experiences into their understanding of the world. This change will lead to a “paradigm shift,” or change in worldview (Weltanschuung). But in which direction? It is between paradigm shifts that things begin to change. Present scientific practice is dominant, can be aggressive, and in the long term is damaging when applied indirectly or directly in a natural world. Indirectly as a consequence of its activity in manipulating and creating dead material, for example, building dams or houses from dead material, concrete, and their secondary effect on the environment. Directly by the investigation into natural phenomenon which demands, unnecessarily at times, the killing of the living to “see how it works.” And again indirectly as a process of the “thinking” scientist, and directly as a physical-emotional disturbance of the organism. These approaches have their uses but unfortunately they are very limited and too dominant. Present scientific practice does not see this limit and keeps “raping” and “destroying” natural phenomena looking for a mechanism to mimic. And mimicking is all we can do at best. There is growing discomfort within the British osteopathic movement. Practitioners are wondering what is going on. Is this it? For years I have felt that osteopaths have subconsciously been either afraid or apologetic about their profession. And I feel that there has been a genuine misunderstanding world wide about this medical philosophy and science. On the usually weak comments you will hear from osteopaths is, “osteopathy is different for every osteopath,” as if this was an excuse for wandering about intellectually over a patient’s body. Without a doubt the treatment for each patient and even for the same patient at a later date should be completely different in action. But the reason why most osteopaths have problems is because they have forgotten their philosophy. Historically the change from the original osteopathic philosophy to the modern era was so slow that they did not recognise it moving away. Unfortunately, osteopaths today mistake philosophy for principles. Usually it goes something like this: Osteopathic philosophy says: 1. the body is a unit 2. the body is a self healing organism etc., etc., etc., These are osteopathic principles not osteopathic philosophy. |
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| UNIVERSAL CONTEXT Osteopathy is a universal Idea and science. Osteopaths are universal practitioners, they approach the patient with a philosophy of wholeness and participation. Osteopaths cannot specialise in a body part but they can “specialise” in a whole body and its presenting condition. This is different from your general practitioner that knows very little about a lot and the consultant specialist who knows a lot about very little. Osteopaths have an on-going Idea about everything. There was the further philosophical movement of Phenomenology championed by Edmund Husserl. Phenomenology further supports the Goethean pragmatic approach of “perceiving the thing as it is.” Any thinking that analyses, for example the total flower in its natural environment goes beyond its total form, resulting from the first steps of a destructive thought approach. Your state of mind begins to break the thing up into pieces and drag it out of context. Contextuality is vital in understanding osteopathic medicine and this is the study of Hermeneutics. Every actor in a play knows their part, but every actor has to know the whole play to understand the context of their part. Even with language words can be written in the same way while meaning something different. “The park keeper would not permit me to enter the park without a permit.” Permit or permit. I bet you had trouble choosing which one is which, because they are out of context. A knee is never a knee until the person arrives. Contextuality is vital in the understanding of the development of osteopathy as well as the context of the patient with the injury in the context of the osteopath. All happens in the present. Since osteopathy cannot take place until the osteopath arrives at it is a little like Schrödinger’s cat in quantum mechanics. All will be explained. Again and again osteopaths talk of quantum mechanics as if it was not only the way forward but also, I suspect in a number of cases, a way out. So what is the connection between quantum mechanics and osteopathy? I’ll leave it up to the physicist Henri Bortoft: “Two-level theory means that there are two levels: a microcosmic and a macrocosmic level. The macrocosmic level means that you look at the measurement. Everything comes down to a measurement. I think that the two-level theory is misleading. Goethe made the distinction between the kind of thinking which begins with the finished product, the object, and the dynamical thinking, which looks, instead at the coming-into-being of that object. The point of quantum physics is not to differentiate into two levels but to look at the coming-into-being of entities. This is a purely dynamical condition.” Osteopathic medicine experiences natural phenomena at first hand. It is an understanding and practice of a coming-into-being. Quantum mechanics demonstrated that the observer affects the observation simply by being there. Practitioners used to experience the coming-into-being of their patients. A simple way of explaining coming-into-being is as follows: Let’s take touch as a sense. Imagine placing your hand into a running stream of warm water. The water would flow around your hands and between your fingers. You are then aware of the form of the water and this form recognition is brought about by the flow coming-into-being around your hand. And don’t forget it is moving, as you are, at all times. Since you have to be there to witness the coming-into-being osteopathy is all P’s: Osteopathy is its Philosophy, Principles and Practice, Practised in the Presence of the Patient in the Present by the Practitioner. It can’t happen at any other time. All natural phenomenona are coming-into-being, but we have learnt since childhood to divide and separate the world. This separation prepares us to break the world into pieces mentally and then to apply mathematics and language to maintain that separation. A good example of the use of language is the term “mind and body.” You know what, “mind and body” only occurs at a language level, you cannot demonstrate them working separately. Language is so powerful only because it intellectually dampens us down. It drowns the imagination and kills the living mentally. Symbols, alphabet and words, block any progression or forward movement, as does this work if it is not put into practise. Can osteopathy deal with psychological problems? In 1899 John Martin Littlejohn published Psycho-Physiology, the lectures of the American School of Osteopathy, Kirksville, Missouri. Again today health professionals have stumbled on what then was obvious. There is no mind so stop trying to put it back with the body. Listening in modern psychology is highly professional. This professional listening is similar to Bortoft’s cheese and trying to find milk: “when you look at milk you don’t call it cheese, although cheese might be the final stage”. Professionals have the situations already worked out in many small situations and terms. When the patient or client talks they can’t here the client too well because they are too busy listening. In cases like depression there is an element of selfishness on the part of the patient. “I” at the centre of their existence has gone too far. Everything is their fault or others are rude to them by simply not looking in the right direction at the right time. But this is not an out of body situation i.e. the mind. They practise this behaviour over and over again as a total concept in everything they do. |
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| OSTEOPATHIC MANIPULATIVE MEDICINE “Imitation is Suicide” Ralph Waldo Emerson You only have to look in osteopathic magazines to see that amount of advertising of courses. And guess what the majority are promising, all forms of manipulation. It is as if manipulation techniques will save us. Dr. Still did not teach manipulation techniques. He knew that the tail would wag the dog, as it is today. Manipulation today starts with the Idea of the finished product. This is what Bortoft refers to as starting with the cheese and then trying to make milk. Techniques of palpation (professional touching) and manipulation have become weak and feeble having little effect on the corrective and healing capability of the body. Professional touching (palpation) is like professional listening, osteopaths feeling in their imagination and then they are unable to feel the patient because they are too busy professionally palpationing Today students of osteopathy are taught “objective literary palpation” meaning “mindless symbolic touching.” In 1937 Paul van B. Allen D.O. wrote a paper titled the Re-Education in Technique in the Journal the American Osteopathic Association, it highlighted the mental activity of the practitioner and not the dominance of the “taught-imitated” technique. “The purpose of this discussion of the subjective factors of skilful technique is to place before you certain considerations which we believe to be true, and certain considerations which we believe to be true, and certain general principles which we ask you thoughtfully to consider with reference to your own technique. We propose to show that in almost every instance our technique falls short of what it should be, both as to the skill with which we apply our own methods, and as to our ability to broaden and increase the scope of those methods by the adoption of new technique.” Allen’s paper could be summarised in the following four points:
Dr. Still taught his physicians to search the body and to leave no tissue unturned. He taught them to feel for inconsistency in the tissues and when found the consciousness of the physician and the gentleness of the interaction would correct the disturbance. As the matter of the patient is already moving don’t try to stop it, it has already slowed down, it needs to be released. This release improves circulation and heals tissue as fast, as is possible. Today osteopaths are trying to find a technique to cure all, just a pill. |
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| DRUGS Briefly, drugs can’t think, sense or reason. The development of drugs in the modern world is the same as the cheese and the milk. We start with the experience of an end product and then back track. Osteopathy was the most complete system of medicine, not because it originally involved the used drugs and surgery sparingly but because of its Goethian philosophy, it involved the values of the physician. This is what made it complete as a natural medical science. A. T. Still wrote the following - ‘Osteopathy is not a drugless therapy in the strict sense of the word. It uses drugs which have specific scientific value, such as antiseptics, parasiticides, antidotes, anesthesia or narcotics for the temporary relief of suffering. It is the empirical internal administration of drugs for therapeutic purposes that osteopathy opposes, substituting instead manipulation, mechanical measures and the balancing of the life essentials as more rational and more in keeping with the physiological functions of the body. The osteopathic physician is the skilled engineer of the vital human mechanism, influencing by manipulation and other osteopathic measures the activities of the nerves, cells, glands and organs, the distribution of fluids and the discharge of nerve impulses, thus normalizing tissue, fluid and function.’ Gallagher at al., 2001. As British osteopaths approach the possibility of limited prescribing we also move closer to extinction. For what little osteopathy we now practise will drift away as the new graduates with their inexperience and lack of philosophy prescribe, rightfully, in an attempt to take away the pain of their patients. Osteopaths would stimulate the body to release the chemicals it already possessed instead of substituting the chemicals in tablet form. In 1938 the America Osteopathic Association held a ballot on the official teaching of pharmacology. The questions asked were the following:
Here is one of the most significant of the 80 plus letters sent in to the Journal: “Gentlemen: The following are my answers to your referendum:
My reason for making this answer is that should you establish a standard course in pharmacology, materia medica and therapeutics, you are going to number among your students a great many men who are unable to get into regular medical college and are only using this means to practice medicine. An evidence of this is the recent change of laws in New Jersey whereby several osteopaths have apparently tried to take the short cut by doing the necessary work and taking the examination, after graduating from osteopathic colleges. I know of one instance where, out of seven men who are practising in one place in New Jersey, three days following the favourable report on the examination, five of them have discarded their osteopathic tables and contemplate the practice of medicine exclusively. I believe that a chair should be established in all osteopathic colleges to teach the art of technique. Osteopathic principles alone are not sufficient unless each student is drilled to the point where he has developed a philosophy that will make him visualise his objective. Many osteopathic graduates have no idea why they are giving treatment, toward what they are directing, nor what they expect to accomplish. Sincerely yours, Charles S. Green.” Since the full teaching of pharmacology in American Osteopathic Colleges less than 10% of osteopaths use their hands, they see it as a speciality. American osteopaths now have been trained to practise medicine and surgery. So Dr. Green was correct and now osteopathy is all but dead in the USA. The only saving grace would have been attention to their philosophy, the rest is history. |
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| THE NON-CARTESIAN ATHLETE Here’s a laugh. Living, breathing, emotional tissue has been reduced to the term somatic, as in psychosomatic. Interesting when you consider the word originally meant, tomb or coffin, as it is the machine for the mind. Once again the body has been killed by terminology and returned to the Cartesian corpse. Athletes have been geometrisiced more than any other human group. Why? Because modern medicine sees the athlete as essentially the pinnacle of health and order. Order is closest to God and naturally mathematics is used to order the universe. Biomechanics is literally the business of sports medicine. Imagine a photo of an athlete in mid-stride over a hurdle. Now impose over that athlete the lines and angles of biomechanics. Now remove the athlete. All that is left, are the lines and angles of Cartesian geometry, the athlete has gone. We are treating by our actions the lines and angles that we have imposed as a second hand and vastly reduced experience of the original athlete. Finally, this is about a physician centred science rather than a patient centred science. Why? The trend today seems to be that the patient is the centre of importance. But this treats the patient as an object separate from the practitioner. It is this objectivity that has to be dissolved, not to be replaced by subjectivity but to include an organic idea of the presence of total participation with no hidden agenda. Many people and books have helped me reach this stage. And as a pragmatic practitioner I now feel free and happy to be certain that my work can never be complete until the next patient leaves my practice well and disease free. This paper is not about discarding what we have, it’s about moving on, and it is not finished. This profession is dying and without a philosophy it will soon be dead. There are powers that run our profession that are driven by control and have such strong paradigms that they would rather kill the very source of their being than change and add an intellectual empowerment of the practitioner. A bit like the scorpion and the frog. “The further one advances in experience, the closer one comes to the unfathomable; the more one learns to utilise experience, the more one recognises that the unfathomable is of no practical value.” The Sorrows of Young Werther, Johann Wolfgang von Goethe. From a forthcoming book, |
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| BIBLIOGRAPHY Bortoft, H. (1996) The Wholeness of Nature – Goethe’s Way of Science. Floris Books, Edinburgh. Enstrom, J. E. and Kabat, G. C. (2003) Gallagher, R. M., Humphrey, F. J. and Micozzi, M. S. (2001) Goethe, J. W. von, (1810): Kaufmann, W. (1958) Midgley, M. (2001) Moran D. and Mooney, T. eds. (2002) © Walter Llewellyn McKone, DO – 2003 |
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| Introduction
to Osteopathic Philosophy Contents |
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© Walter Llewellyn McKone, DO – 2003 Contact wmckone@osteopathicphilosophy.com |
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