DEAR DR. STILL, WHAT WERE YOU THINKING?

21/04/2019

After all these years, after all these changes in our society – cultural, economical, pedagogical, … - we can ask ourselves what is the basic premises to be an osteopath. Many claim to have the answer – some even claim to know the answer. Would it not be much more logical to ask Dr. A.T. Still himself and see what he has to say on the subject? After all, he is the founder of Osteopathy – isn’t he?

(This article was originally published in 2008 in the Netherlands as well as in Germany; small changes to the text appear in this new English edition – thanks to J. Haxton by his FaceBook-support)

PREFACE

 

A.T. Still claims that the key to his philosophy lies in the knowledge of anatomy. Acquiring this knowledge is not a small task. Unless one is limited to the essential parts of the anatomy. But the question arises what is essential from an anatomical and osteopathic philosophical point of view? Is it because of the term "Osteopathy" about the knowledge of bones? To what extent is a word or image representative in order to define what an osteopath needs to know to be able to work in the spirit of Still's philosophy? If we want answers to these questions then it seems best to ask Dr. A. T. Still himself. How? It seems to be the easiest by reading his books and studying the complete anatomy. And the latter both through books and dissections.

DEAR DR. STILL, I HAVE A FEW QUESTIONS

 

For many osteopaths, this photo is certainly a familiar image. A man is looking at a femur. In this case it is Dr. A. T. Still holding a bone in his hands. Dr. Still, the founder of osteopathy holding a bone. Dear Andrew Taylor Still, by this picture, do you want to make it clear to us that Osteo-Pathy has something to do with pieces of bone? Or did you play with the idea to put us on the wrong foot? What did go through your mind at the moment when this photo was taken?

We know from your literature how much of your attention has gone to anatomy. In your autobiography you repeatedly tell us what meaning you have given to the human existence from the perspective of osteopathy. You say "... I devoted my attention to the study of anatomy (1)". The word "devoted" leaves no doubt how fundamentally important you consider this knowledge to be. In the same stroke of your pen you underline the essential value of anatomy for your entire knowledge, whereby you do not rely solely on literature, "... I had printed books, but went back to the great book of nature as my chief study. ... The best way to study a man is to dissect a few bodies (1). Dear Dr. Still, perhaps you exaggerated a little bit in the number of self-dissected specimens. Perhaps you only wanted to point out to the reader how important it is to study anatomy not only from books but directly from humans as well. Perhaps it is due to the fact that you put more confidence in your own eyes instead of simply deducing it from books. Your life is characterized by your own observation. Already at the start of your autobiography you tell the reader: trust only what you have seen and experienced yourself. For example, in the numerous cited examples you write: "... I determined to go and see it was true before I told it to Dick ... (2)". Only a few pages later you once again underline the importance of your own observation, "... If he is observing he learns more .... for he has the great book or nature constantly spread before him (3)".

 

Dear Dr.Still, in the photo we see how you look at a Femur. At least that is what we think we see. However, the question that can be asked is: what did you really have in mind? What image actually formed in your mind at the time? This image must have been more than just a Femur. Otherwise, why do you say "... you should be familiar with at least ninety per cent or all the human body before you enter our clinics (4)". A little bit further you even claim „... Osteopathy cannot be provided by books only. Neither can it be taught to a person intelligently who does not fully understand anatomy both from books and dissection (5) ”. Did you, Dr. Still, had just a Femur in mind? It is possible but difficult to imagine.

 

The photographic recording with the Femur closely matches your statement "... with the theory firmly fixed in mind that the greatest study of man is man, I ground with the skeleton (6)". However, he or she who claims that this photo and this statement confirms the personal line of thought, “osteopathy has only to do with pieces of bone...”, well, one can ask yourself whether this really went through your head when you were in front of the camera then. It is not unthinkable but difficult to believe. It is difficult to accept because you clearly state "... you must be thoroughly acquainted with all that is meant by anatomy ... (7)" in which you, in the same sentence, still emphasize the importance of muscles and nerves , veins and arteries. Dear Dr.Still, what were you thinking? You claim that it is completely logical that for someone who has become acquainted with anatomy, it is clear to everyone who has understood this anatomy as a part of a living machine, that “disease” obviously is only an effect? You want to claim that these effects are caused by nerves that partly or completely do not function properly, as a result of which the fluid of life cannot flow properly (8)? And now, through this photo, where you look at a Femur, you want to seduce us to the idea that osteopathy only has something to do with pieces of bone? Dear Dr. Still, where were your thoughts?

 

Alright alright, you dont have to become angry! We do know that you claim in the same sentence "... It appears perfectly reasonable to anyone born above the condition of an idiot (8). So this would mean that when we look at the photo we should certainly not come to the idea that you are only looking at a Femur. If we came to the conclusion that osteopathy only has something to do with pieces of bone, this would mean, according to your statements, that we apparently didn't understand much of your philosophy and therefore consequently neither of your work.

 

The question is, however, why are we playing with the idea that osteopathy has (only) something to do with bones? Where does this line of thinking come from? Certainly not from you! While you are holding a bone in the picture, you claim, "... One who does not know this preparatory branch is completely lost in our operating rooms. He does not act from reason, because he does not know enough anatomy to reason from (9)”. The knowledge regarding pieces of bone is certainly not "enough". By the way, you indicate that the knowledge of anatomy forms a basis for your philosophy (9). You even claim that it is completely useless to teach someone how to treat diseases from the viewpoint of osteopathy if this person was not first taught the anatomy knowledge with great care. (9). While in the photo you hold a Femur in your hands, you inform the reader in your autobiography "... When you are dealing with a diseased liver or any other organ or part of the body, remember the highest officer in command is the artery of nourishment, which must be assisted by the nerve of motion and the vein of renovation… (10) ”; Does this mean that osteopathy is much more than just putting together some pieces of bone? If you claim that anatomy is the basic knowledge that leads to your philosophy, does this mean that a knowledge of anatomy limited to bones implies a limitation on access to your philosophy? Is the key to understanding your philosophy a knowledge of anatomy as a whole? Do you want to make it clear to us that we must devote ourselves to a study of the whole anatomy so that we can understand your philosophy and your work? But dear Dr. Still, you know all too well that this is not an easy task. After all, don't you claim yourself "... I told him it was a gift of life long hard study, and the result of brain-work used in studying standard authors of anatomy (11)". Anyone who wants to master the principles of osteopathy should therefore first consider the anatomy according to your statements (11). But where should we start then? You advise an inexperienced student to start with a specific book before you can further help him understand osteopathy (11). Dear Dr. Still, do you have any idea how many anatomy books we have today? All right, it may be true that there are more books than in your time. And we even have them in a digital form today! However, it is also a fact that it is precisely the simplest picture booklets that are usually chosen today. There you have it.

 

Each of these books begins in its first chapter with the description of the bones. So if you claim that you started your studies with these bones, then these books are in line with one of your statements (6) and ... therefore also with the photo on which you look at one of them. But if we look more closely as well as more further than just the length of our nose, it looks very much as if you are not trying to fool us. Our own interpretation of the photograph and how you hold a Femur there, the meaning that this image is given by some of us today, it seems to be for many an alibi. An alibi for a personal anatomical short-cut. This seduces us to conclude that we are putting ourselves on the wrong foot. We fool ourselves!

 

Dear Dr.Still, what were you thinking? A picture says more than thousand words. If you had known to which interpretations and which meaning this picture has lead today, one can ask the question if this photograph would have gotten your approval. But okay, eventually it is only a photograph and which meaning we give to it is in the end our own responsibility. The answer to the question if this really is what you had in mind reflects clearly in the words coming from the pen in your own hand. In this you state clearly that the key for your philosophy lies within anatomy. And that is more than only some knowledge of pieces of bone and which one cannot acquire from books only. Thus, a photograph says not more than thousand words and it is for sure quite difficult to extract the thoughts behind it. Therefore the question remains: Dear Dr. Still, what were you thinking? Most likely it will remain a secret forever what went on in your mind the moment this picture was taken. However, one thing you did make crystal clear, didn't you?

 

Source

 

(1)  A.T.Still, autobiography of A.T.Still, page 84

(2)  A.T.Still, Autobiography of A.T.Still, page 24

(3)  A.T.Still, autobiography of A.T.Still, page 34

(4)  A.T.Still, autobiography of A.T.Still, page 152

(5)  A.T.Still, autobiography of A.T.Still, page 162

(6)  A.T.Still, autobiography of A.T.Still, page 86

(7)  A.T.Still, autobiography of A.T.Still, page 152

(8)  A.T.Still, autobiography of A.T.Still, page 94

(9)  A.T.Still, autobiography of A.T.Still, page 162

(10)A.T.Still, autobiography of A.T.Still, page 191

(11)A.T.Still, autobiography of A.T.Still, page 126

Image: A.T.Still, Osteopathy – Research & Practice, Coverpage