Osteopathic medicine (OM) is a distinct system of medical practice in the United States, providing a comprehensive approach to patient care by fully licensed physicians, known as Doctors of Osteopathic Medicine (DOs). This medical philosophy emerged from widespread dissatisfaction with 19th-century medical treatments, often called “heroic medicine,” which relied on harsh substances and practices such as bloodletting. The foundation of this new medical system was officially established in 1874 by its founder, Andrew Taylor Still. Still’s concepts offered an alternative to the prevailing methods, emphasizing the body’s innate ability to heal itself.
Andrew Taylor Still: Early Life and Influences
Andrew Taylor Still was born in 1828 in Virginia, growing up on the American frontier as the son of a physician and Methodist minister. He received his early medical training through apprenticeship with his father. Still later served as a hospital steward during the Civil War, gaining extensive experience with battlefield injuries and conventional medical treatments. This exposure led him to question the efficacy of the medical practices of his day.
The pivotal event that spurred Still’s search for a new methodology was a personal tragedy in 1864. Three of his children died within a few weeks from spinal meningitis. This devastating loss cemented his rejection of prevailing medical theory and practice, driving him to dedicate the next decade to intensive study of anatomy, physiology, and the natural laws of health. He became convinced that the body contained all the necessary components for health and that disease was often a result of mechanical interference.
The Declaration of 1874
After years of meticulous study and philosophical development, Andrew Taylor Still formally introduced his new medical concept in 1874. This date marks the intellectual founding of osteopathic medicine, a moment Still famously described as “flinging the banner of Osteopathy to the breeze.” The public declaration took place in Kirksville, Missouri, where Still had relocated to begin practicing his new approach.
Still’s new system was rooted in the idea that the body was a finely tuned machine, and that health could be restored by fixing mechanical problems within it. He began to practice a form of manual therapy that focused on the musculoskeletal system to restore proper function and circulation.
The Foundational Principles of Osteopathy
Still’s philosophy was distilled into a set of core principles that guide Doctors of Osteopathic Medicine today. The first principle states that the human body is a unit, meaning the person is a unified entity of body, mind, and spirit. A second principle asserts that the body is capable of self-regulation, self-healing, and health maintenance, suggesting that the physician’s role is to facilitate these inherent processes.
The third tenet establishes a reciprocal relationship between structure and function. Still believed that if the body’s structure, particularly the musculoskeletal system, was impaired, its function would be negatively affected, and vice versa. Finally, the fourth principle dictates that rational treatment must be based upon an understanding of the first three concepts.
Establishing the First School and Early Development
The success of Still’s method in treating patients led to an overwhelming demand for others to be trained in his techniques. In response to this need, Still established the American School of Osteopathy (ASO) in Kirksville, Missouri, in 1892. The founding of ASO marked the institutionalization of the philosophy he had declared eighteen years earlier. The first class admitted twenty-one students, notably including several women and members of Still’s own family.
Early practitioners faced significant opposition from the mainstream medical community. The first state to legally license osteopathic physicians was Vermont in 1896, beginning the profession’s slow but steady fight for legitimacy and full practice rights across the country. The ASO’s curriculum focused heavily on anatomy, physiology, and manipulative methods.