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| Book Review “Ostium” Quarterly Journal for the Australian Osteopathic Association | ||||
| Osteopathic Medicine:
Philosophy, Principles and Practice. W. Llewellyn McKone D.O. Blackwell Science Ltd – Books $96 plus GST |
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| Years ago, a famous American osteopath visited
Sydney. As we all know, the expert is always the bloke from out of town,
and we paid our money and drank in his every word. This fellow loved to skite, and we loved to listen. He told us how wonderful osteopathic medicine and to prove it, he told this story. He had been sitting in church one Sunday (as they do) and had noticed that his fellow parishioner, a radiologist, had been eructating through out the service. He asked the radiologist if he drank a lot of milk.’ Yes’, he replied. ‘Well’, our osteopath said, ‘I believe that you are drinking the milk to neutralize acid and that you have a gastric ulcer’. The radiologist disagreed, but our man, after explaining what he was about to do, palpated the others mid-thoracic spine and found, much to the radiologist’s surprise, tenderness and asymmetry. That week a gastroscopy confirmed the diagnosis. Our man finished his story and we sat there, silent and perhaps a little confused. So? That’s a pretty lame story, and we were puzzled that he was looking particularly chuffed. Finally, someone piped up and said “How did you treat it?’ Our visitor looked surprised. ‘With zantac, of course!’ Here we had a clear demonstration of modern American osteopathy. It’s a shame. Being an osteopath, a real osteopath, can be a lonely place. All you have is your hands, your bench and a belief in a philosophy that is barely accepted, except by you, your clients and your colleagues. Some of your colleagues. Of course, you can see that it works, but such primitive evidence, such phenomenology, such anecdotal evidence counts for next to nothing in this world. You spend years defending it, years explaining it, and finally years keeping to yourself, sick of the conversation. If you buy this book, your loneliness will ease. It is wonderful. Finally, here is a definitive, warm and comprehensive history that puts our loved philosophy and craft into a profound historical and philosophical context. The author then explores metaphysics, anatomy, physiology and again anatomy, osteopathic and other principles, psychology, concepts of health and disease, pathology and finally, practice. McKone is an Englishman, and this book, unlike recent tomes from the USA, is proudly and unapologetic in it’s deep commitment to osteopathic principles and practice. It was not written to placate insurers and the medical profession. Look up heart disease in the latest standard American texts, and you read about surgery and pharmacology. McKone gives us…osteopathy. But this is much more than an osteopathic text. McKone places osteopathy in both an historical and cultural context, starting with a short history of science and medicine, from Pythagoras, Hippocrates (who wrote ‘our natures are the physicians of our diseases’), Plato, Aristotle and through to the empirical Copernicus; the mind/body dualism of Descartes, which still pervades medicine, the mathematic certainty of Newton and finally the idea of inter-relatedness and organic form proposed by Goethe. The rise of Protestantism in the 18th century was a late precursor to the development of osteopathy – ‘John Wesley studied medicine and developed his brand of prevention and treatment consistent with Methodist principles. His system was that of a unifying concept of body and soul, with disease as an obviously a discontinuity of this harmony… he advocated the simple life and natural way of prevention and treatment.’ Still was a methodist. His father before him was a Methodist fire and brimstone preacher and a ‘physik of the people’. This explains a lot of what we see in present-day osteopathic practice and piousness The industrial revolution of course set us well on the path to the development of current reductionist scientific thinking. Then the American Civil war, with its massive death toll and even larger legion of sick and wounded demonstrated the primitive and inadequate quality of then current medical practice. This was fertile ground for the development of another form of medicine -Osteopathy. Still had rejected as ineffectual the current regimes of homoeopathy, native American medicine, water and emetic therapies and the heroics of the allopaths – he had watched helplessly as five of his children and his first wife died, and had developed a deep distrust of homeopathy, ‘heroic’ medicine and within his puritan tradition, alcohol. He had no formal education, and this ‘peasant’ unstructured education would have significance to the development of osteopathy. He described nature as a ‘natural mechanic’, influenced undoubtedly by the ongoing industrial revolution, which would transform rural life in particular, and echoing his Wesleyan tradition and probably unknowingly, the ideas of Goethe, Hegel and those before them. This is how McKone puts osteopathy into context, and with that he puts us into context. We are not shouting in a hurricane. Books like this give us voice. We are practitioners of a medicine with a long and respected history – even though, until now, we didn’t know it. We too have been taken in by reductionist paradigm – we want acceptance on one hand but on the other, reject the accompanying limitations that would necessarily ensnare us. Look at the mess the Americans are in. We try to be all things to all people - and this is well demonstrated by attempts to ‘science up’, for example, the art of palpation and clinical diagnosis, which doesn’t seem to credit ‘gnosis’ at all. 'The father of osteopathy was essentially a hillbilly farmer…who worked in harmony with nature…only believing what his eyes and hands taught him. He was blessed with a simple organic consciousness…consequently his work and teachings have been misunderstood by latter day osteopaths and dismissed as quackery by the over-educated medical establishment. So much that these so-called medical minds, constrained by their mathematical style of consciousness, systematically applied academic subversion – resulting in the eventual disempowerment and contamination of osteopathy’. McKone makes no apologies and his book is an accurate reflection of all our clinical experiences – that the agent of osteopathy is the osteopath, and that osteopathy is a system of medicine, borne of holistic principles and mediated through our senses, delivered through our skill. It lies in an loveless, doomed embrace with reductionism. It will end in tears. If you are feeling jaded, if you feel that you’ve lost your passion and idealism and energy for what you practice – whether you are a student or a practitioner - read this book. It should be a required text for all students, to counter the poisoning of our well. When you buy this book, you will know better where you came from, what you are, what you do and why you do it. That’s a great start to the rest of your working life. Anne Cooper DO |
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