Osteopathic Philosophy - The Osteopathic Philosophical Society

THE OSTEOPATHIC
PHILOSOPHICAL
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“In order to get the proper perspective and setting of Dr Still’s ideas we believe it will fully repay the student to note the essential features of the thoughts of the early Greeks, of Descartes, Copernicus and Galileo, of Hobbes, Locke and Hume, of Darwin, Goethe, of Fichte and Hegel, of Darwin, Spencer and Huxley, to mention just a few, and the leading men of recent and present times…

To the interested reader a study of the present day philosophers will prove a corrective. One can derive both pleasure and profit in such readable works as those of Lotze, Eucken, Münsterberg, James, Bergson, Dewey, Russell, Schiller, Royce, and from the scientific side the late work of More, “The Limitations of Science.” ”
Carl P. McConnell, D.O.
The Teachings of Dr. Still.
The Journal of the American Osteopathic Association, August 1915. P. 641-64

“Neither osteopathy nor surgery, let alone dentistry would have got very far by ignoring it (the organic approach)…They are directly related to mental operations, which are developed in the philosophy of Phenomenology, itself a post-Cartesian outlook. Relating this method to current philosophy of science it (osteopathy) 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 the Cartesian. Again, the only real problem with this approach is the fact that very few know of its existence.”
Toward a Man-Centred Medical Science.
Foreword by René Dubos,
The Rockefeller University, New York, New York. 1977.

“To those human beings who are of any concern to me I wish suffering, desolation, sickness, ill-treatment, indignities - I wish that they should not remain unfamiliar with profound self-contempt, the torture of self-mistrust, the wretchedness of the vanquished: I have no pity for them, because I wish them the only thing that can prove today whether one is worth anything or not - that one endures."
Friedrich Nietzsche,
The Will to Power, p. 481

Andrew Taylor Still was adamant that osteopathy was a philosophy. And it was only on this base that Osteopathy could move into principles and only then could be delivered as clinical practice. Over time and with a change in the philosophy of the Western world this philosophical approach has dissolved leaving principles and practice as the interpretation of osteopathy. With the original philosophy now missing the more mechanical-objective/subjective philosophy of the modern world has taken over.

This mechanical-objective/subjective approach is misleading and has left Osteopathy a little one-sided and disempowered. Principles and practice are at the mercy of this recent philosophy, reducing the body and mind to separation, dominating with the body as the soma and allowing manipulation and palpation as the end result becoming the driving force and rationale for the being of Osteopathy. This was not the original Idea.

Osteopathy today is understood as palpation and manipulation this is starting with the end. Anybody can palpate and manipulate. So what is the factor that makes an osteopath separate from other forms of health care? As quoted above it is the mental operation of the osteopath that is important. The Goethean approach places the osteopath and their Weltanshauung, paradigm or world view at the centre of the osteopathic concept, not the palpation or the manipulation - that comes later. On this basis Osteopathy was a physician centered medicine but has become a patient centered manipulative approach.

In 1937 Paul van B. Allen, D.O. wrote a paper titled the Re-Education in Technique in the Journal of the American Osteopathic Association, which 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 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.”

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Allen’s paper could be summarised in the following four points:

1		Teachers, students and practitioners are constantly concerned with the end to be gained to the almost total exclusion of any consideration of the means whereby that end is attained;
2		because we have followed a process of intuitive imitation both as we began to learn technique, and later in any effort to add new methods to our armamentarium;
3		we have followed the trial and error method rather than that of reason; and
4		quite inclusively, because of the very nature inherent in the methods by which we learn and continue to learn technique.

And here’s a few more references from Carl P. McConnell, D.O.:

“At this late date many seem to forget that a basic discovery of Dr. Still was the fact of immunity…. The whole living structure (not just the backbone) which embraces function, or vice versa, is something more than just a sum of the parts; and the sum of the parts is not confined to one class of tissue, e.g. bones…. The practical everyday problem resolves itself into what the individual measure of the particular case is. It is not a composite collective one, but composite and unified, with multiplicity in unity. ”
JAOA , March 1935.

For an understanding of multiplicity in unity see “Goethe’s Organic Vision” on this site.

“The idea of separateness should be obliterated. Not appreciating this to the full is a pitfall. So striving to get the bones in normal position, per se or perhaps to keep them in position is simply hopeless. In this regard, the bone item is simply an idol, and a similar idol could be made of the muscles, and so forth.”
JAOA, April 1935.

If this is the case then how come we have got it so wrong?

This idea of separateness is fundamental to differential diagnosis, specific techniques to specific tissues etc. Treating (techniquing) the body as a series of tissues out of context leads to a weak body response. Poor context, poor recovery. It’s not my foot that walks down the road; I walk down the road. There isn’t pain in my knee; I hurt, with emphasis on my knee. We feel pain in one area because we can exclude other areas with language.

“A modicum of anatomical study and clinical investigation will reveal that there is tenderness, tenseness and congestion over one of the foramina mentioned above, in exact accord to the area structurally involved. Furthermore, no great skill is required in order to obtain results – only light manipulation and accuracy of application (every few hours) wherein even the patient can be instructed.”
JAOA, November 1934.

Can this get any better? I think it can. When are we going to realise that we have got it wrong, fantastically wrong, and only we can put it right? It reminds me of the sporting cliché, “snatching defeat from the jaws of victory.” We have stopped treating our patients - we are now techniquing them. The emphasis on manipulative techniques is one thing at undergraduate level but in the real world it leaves you wanting.

We have been taught what to palpate not how to palpate. Formal manipulative procedures result as soft tissue, high velocity thrust, muscle energy, strain-counterstrain, cranio-sacral etc leaving the ill body cold and poorly responsive.

We need to return to the old style non-segregated Osteopathy as a practical philosophy if we are to take our rightful place in the world of health care as real physicians who return the patient to “normal.” A large number of colleagues resist any idea that there is an original osteopathy and cannot see past the reductionist biomechanical approach.

The most unscientific act is refusing to read information about Osteopathy. Repeatedly I hear osteopaths say, “Walter has a different view.” I repeatedly reply, “It’s not my view, it’s written down.” This refusal to read is the result of fear mixed with vulnerability. I’ve read Gray’s Anatomy, Kapandji, and all the other books on medicine and physical therapy. If I’m wrong please prove me wrong by reading the books I have read and then make a comment. By the way we will have book reviews on the site.

Don’t forget there are the high priests and priestesses of doubt and control who cannot bring themselves to admit they have got it wrong. There are those, who taught you and me, who would rather see us all stay in the realm of physical therapy (no offence to physical therapists intended). As long as we all die together and they stay in charge with the same arrogance that denies the sinking of a ship when the water is just below their chin.

The Osteopathic Philosophical Society (OPS) is unique both at an undergraduate and graduate level. Schools of osteopathy worldwide teach philosophies and concepts of all kinds, if at all, but not one teaches the osteopathy philosophy. Web sites claim to inform on the subject of osteopathic philosophy, but once you have entered the site what you are informed about is osteopathic principles.

The philosophy of Osteopathy is simple; it is known as Biogen and can be found in The Philosophy and Mechanical Principles of Osteopathy by Andrew Taylor Still. This stops all the bickering over what osteopathy is and what it isn’t. Biogen is what is known in philosophical circles as philosophical utterances, in this case the philosophical utterances of Andrew Taylor Still.

OPS was formed to rekindle the original osteopathy as a practical philosophy and to try and achieve the following:

To return osteopaths to the status of philosopher physicians rather than their present state of manipulative technicians. The word physician means, “to return to normal” not giving drugs. Your mum can give you a tablet, it doesn’t make her a physician.
To return osteopaths to the status of inquirers and practitioners of a clinically applied anatomical philosophy called Osteopathy.
To return Osteopathy to an Eubrotic (health) based Medicine.
To return osteopaths to the status of "bloodless surgeons."
To promote the reading and application of ideas listed by McConnell and their clinical significance.
To be inclusive of all forms of philosophy, principles and practice.
To return to the original osteopathic concept of disease in the light of present misunderstanding and struggling of the medical profession to understand disease.
To promote and educate osteopaths and the public in the Moral Philosophy of Osteopathy in the promotion and understanding of health and disease.
To equip osteopaths and the public with the reasoning skills in relation to health and disease.
To promote osteopathic research on the basis of the organic participatory ideas of the natural philosophers.
To promote open debate between osteopaths and the public.
To write and speak of philosophers in the present tense.
To never personally attack a contributor in any shape or form. We always comment on what has been written and said. Any criticism must be directed towards a point of correction and must be supportive of the author and society. You’ll get chucked off by me.
To support and listen to anybody with any (bright) ideas.

Everything on the OPS site is free.

Anybody who would like to donate papers to the site, can be proof as part of their CPD as Learning by oneself.

The Continuing Professional Development set out by the General Osteopathic Council states: “Learning with others – any type of activity that involves interaction with osteopaths, healthcare practitioners or other professionals.” This includes the participation through the site involving the online forum.

The OPS has an official website: www.osteopathicphilsophy.com which provides an arena for education, papers, letters and debate via the online forum.

Walter Llewellyn McKone, DO
2004

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