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BACKGROUND/HISTORY

The use of manipulation is as ancient and widely practiced among various cultures as the field of medicine itself. The first documented writings on manipulation can be traced back to Greece, where Hippocrates (460–385 BCE) described using gravity and traction techniques to treat scoliosis.1 Other notable figures in medicine also referred to the use of manipulative procedures, such as Galen, Celisies, and Oribasius.2 Manual treatment was developed further in Europe by generations of “bonesetters,” manual practitioners who passed on the art of technique from one family member to another. The bonesetter's approach evolved as medically trained practitioners moved toward more pharmacological approaches.3 Wharton Hood, MD, a 19th-century British practitioner, devoted a great deal of time to studying the procedures of bonesetters. He even published papers in The Lancet in 1871 that reported the effectiveness of manipulation in the relief of musculoskeletal problems.4

At the turn of the 19th century and even a bit beyond, turmoil was present in the medical community and, in spite of huge strides in scientific investigation, medicine had changed little.1,2 One individual eventually would take a radically different path to healing—a man called Andrew Taylor Still.

Still (1828–1917) was greatly influenced in his pursuit of medicine by his father, a physician and Methodist minister. In the mid-1800s, a person could become a physician through an apprenticeship. Still likely attended only one seminar of formal medical education, as he believed it uninspiring. He seemed well aware that the current medical treatments, including bloodletting, could inflict more harm on patients than if they were left alone.1 His disenchantment with the medical practices of the day came to a culmination when he lost three of his children in a single outbreak of spinal meningitis.1,5 In April 1874, he coined the term “osteopathic medicine.”2

Still believed that rather than treating only the symptoms of a disease with harmful agents such as alcohol, mercury, and large doses of opium, a doctor should attempt to discover the cause of the disease itself. He originated the concept of wellness and developed principles of proper exercise and diet to prevent disease.6 The best summary of this philosophy is expressed in Still's own words: “To find health should be the object of the doctor. Anyone can find disease.”7 He also noted that circulation was of the utmost importance, proclaiming that “the artery is the father of the rivers of life, health, and ease, and its muddy or impure water is first in all disease.”8

It is unclear when and how Still added manipulation to his philosophy of osteopathic medicine. Interestingly, he did not write a book on manipulative techniques. His writings instead focused on osteopathic philosophy, practice, and principles.2 It was not until 1879 that he became known as the “lightning bonesetter.”2

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