[NOTE: Dr. Jordan, a practicing osteopath in Columbus, Ohio, and an A.R.E. member, has devoted several years to researching early osteopathic literature, the better to understand the Edgar Cayce readings that recommended manipulation and its role in health care. The following article was published in Venture Inward, July/August 1994, Volume 10, No. 4.]
Osteopathic treatment is of the most frequently recommended therapeutic measures suggested in the Cayce readings. Chiropractic adjustments are recommended only occasionally. This has caused much confusion for contemporary physician practitioners because osteopathic and chiropractic manipulative treatments seem so similar today.
A look at the development of osteopathy and how it was originally practiced shows how it differed from chiropractic. More important, osteopathy in philosophy and practice more closely reflected the healing philosophies of the Edgar Cayce readings.
Osteopathy was developed by a Midwest physician, Andrew Taylor Still (1828-1917).When three of his children died of meningitis despite the best available medical treatments, he began to question the exceedingly harsh and seemingly useless practices of his day. This led him to search for a better understanding of health and disease.
Dr. Still dissected many human corpses, thus gaining a knowledge of anatomy that was legendary.
" A thousand experiments were made with bones until I became quite familiar with the bony structure. I might have advanced sooner in osteopathy had not our Civil War interfered with the progress of my studies."
Nine years after the war ended, in 1874, Dr. Still advanced his concept of osteopathy. He believed that the human body, being a work of God, was perfect and inherently had all the properties needed to maintain a state of health. Disease only existed if there was some obstruction to health such as impaired circulation of blood, lymph, or nerve forces. The osteopath need only remove this obstruction, he reasoned, and the body would then naturally heal itself.
In his autobiography, Still traced his confidence in manipulation as a healing therapy to an incident when he was 10 years old. Suffering from a headache, he lay on the ground with his head resting on a blanket that lay over a rope tied between two trees about eight to ten inches above the ground."Thus I lay stretched on my back, with my neck across the rope.' He fell asleep and woke up feeling fine."I followed that treatment for 20 years before the wedge of reason reached my brain, and I could see that I had suspended the action of the great occipital nerves, and given harmony to the flow of the arterial blood to and through the veins, and ease was the effect." He came to believe 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."
He viewed the body allegorically as a "finely tuned engine" and the osteopath as a mechanic whose job was to correct any parts of the engine that were out of order.
Dr. Still taught that when a bone or vertebra is slightly out of position there is also a strain on the surrounding tissues including the ligaments, muscles, blood vessels, nerves, and lymphatic vessels. This strain causes a decrease in the local circulation of fluids and alteration of the nervous impulses. Disease results when tissues and organs:
- Do not receive sufficient arterial blood supply to provide them with oxygen and nutrients
- Do not have properly balanced nervous supply to regulate and coordinate their function with the rest of the body, and/or
- Do not have adequate drainage through the veins and lymphatics to carry away their wastes.
The osteopath's duty was to help elicit the body's natural healing forces by removing any obstruction to health. This most often meant correcting the bony misalignment so that all the surrounding tissues and nerves could work unimpeded.
"Remove all obstructions, and when it is intelligently done, nature will kindly do the rest," Dr. Still wrote. He also often said that anyone can find disease, but an osteopath's job is to find health.
Many parts of the Edgar Cayce readings and their recommendations parallel the osteopathic philosophy of health. A book that outlines the similarities between these two systems is Osteopathy: Comparative Concepts - A. T. Still and Edgar Cayce, written by J. Gail Cayce.
The Cayce readings contain many very complimentary comments about osteopathy of that day, such as: "There is no form of physical chemotherapy so near in accord with nature's measures as correctly given osteopathic adjustments." (reading 1158-31) Also, "... and nature is better even than the osteopath - though the osteopath is the closest to the natural means." (1497-4) "Seek out, then, an instrument of the curative forces known as the osteopath, that is capable - through the proper manipulations, using the structural portions of the body as leverage - of stimulating the secretions through the various activities of glands and centers and ganglia along the system to bring about a coordination of the activities of the physical forces within the system itself." (531-2)
Cayce seldom recommended chiropractic treatments and even on occasion warned against them. What was the major difference that Cayce saw between the two schools of practice at that time which influenced him to suggest osteopathic much more often than chiropractic treatments?It seems that the primary difference between osteopaths and chiropractors of that day was their method of adjusting the body. Before these differences can be explained, a clarification of terminology is essential.
A bone out of proper alignment is termed a lesion, or a subluxation, or somatic dysfunction. There are many ways to correct these misalignments; but they fall into two therapeutic categories, the direct and the indirect techniques.
Most direct techniques are associated with the popping or snapping of joints, usually the vertebrae of the spine. In many direct techniques, the operator applies a thrust that is directed to force a displaced bone back into position. If a single vertebra is displaced so that it is rotated and facing slightly to the right, the thrusting technique forces that vertebra to the left with the intent of leaving it centered in the midline where it should be. This is achieved, once the patient is positioned, by a quick thrust which causes the joint spaces to open, producing an audible pop. This mechanism is the same as when people crack their knuckles. The sound is produced as two joint surfaces are quickly pulled apart, creating a small vacuum. The same effect is achieved by pulling a small suction cup from a smooth surface. This does not directly damage a joint, and often frees any restriction. Injury to the surrounding ligaments can occur only if the operator puts too much force into the motion, thereby stretching the surrounding ligaments beyond their physiologic range.
Depending on the operator's intent and skill, this thrust can be very specific and only adjust one segment. With a slightly different approach, many joint spaces may be opened quickly, producing a crunch sound instead of a single pop. It appears that early chiropractic adjustment was administered in this way - with quick thrusts to correct any vertebrae that might be out of place. Over the years many variations on this basic technique have been developed. Some use a great deal of force, while others are quite delicate and specific.
Dr. Still and the early osteopaths who trained under him seem to have rarely used these direct techniques. Instead they used much gentler, indirect techniques. Their method of correction involved gentle exaggerations of the position of the dysfunction until the tensions in the ligaments were felt to balance. Then the job was to wait, feel for the body itself to correct the dysfunction, and to assist gently the body's natural corrective movement until the bone returns to normal, or to a more normally balanced position. For example, in the case of a vertebra facing slightly to the right, instead of thrusting it to force it left, the osteopath would gently exaggerate its position; turning it even more to the right until a balance was felt, then allowing the body's intrinsic forces to take over and return the vertebra to its proper position. The main focus of the operator is on the tension of the surrounding ligaments and muscles. The corrective action comes not from the physician, but from the body's natural healing forces.
Ample evidence of their preference for indirect techniques is found in the writings of some of the early osteopaths. Indeed, they even warned against the harsher direct techniques.
"I don't think I ever saw the 'Old Doctor' (A. T. Still) snap a joint with any noticeable sound, "writes M. L. Bush, D.O., who boarded with the Still family while a student at the first osteopathic school."His technique was practically painless to the patient. I have often heard him say, ‘When you hurt a patient in treatment, you don't deserve to be called an osteopath."
G. V. Webster, D.O. summarized their philosophy when he wrote: "Living things prefer persuasion to force, consideration to trauma, intelligence to ill-expended force. It is better to work with the tissues than at them. Nature has her rewards and penalties for the manner in which lesions are treated. Co-operate with nature."
Edgar Cayce echoed this in reading 1158-24: "Then the science of osteopathy is not merely the punching in of a certain segment or the cracking of the bones, but it is the keeping of a balance by the touch - between the sympathetic and cerebrospinal system!" and "With the adjustments made in this way and manner, we will find not only helpful influences but healing and an aid to any condition that may exist in the body...... Also, "A long series of such (osteopathic adjustments), just pulling or cracking here or there, has nothing to do with healing forces!They have to be scientifically or correctly administered for the individual or particular disturbances, just as we have indicated here."
Reading 304-2 further explains this difference: "Osteopathic treatment is needed, not chiropractic. If we had wanted this we would have given it. The body does not need adjustment, what it needs is relaxation of the muscular forces .... Chiropractic treatment is adjustment, not relaxation of the muscular forces."
Not every dysfunction will fully correct on the first treatment but the osteopath's job was to acknowledge the body's wisdom and allow the body to correct itself at its own pace. As C. P. McConnell, D.O. wrote, "Always make it a point when working upon dislocated vertebrae in any region that just as soon as one has obtained a slight movement in the lesion do not attempt to correct it any more for the time being. A slight movement toward the right direction may be all that is necessary to relieve the ill effects of the lesion. In fact it might be impossible to get the lesion anatomically correct......
Likewise, reading 2519-3 states: "...but to act in the manner as will allow nature itself - for, this - this would be well for all physicians of every character to remember: That they may only aid nature to; adjust itself. You can't force nature to do anything! Only aid it in adjusting itself to meet conditions."
Along with these indirect techniques, osteopaths also used a number of different approaches to correction. Some osteopaths preferred direct techniques to correct vertebral misalignment, but even these techniques were performed gently and without much popping or cracking of bony joints. Edythe Ashore, D.O., in a 1915 osteopathic text, wrote this about treating the neck: "The habit of putting a cervical joint upon tension and 'popping' it is one to be condemned in no uncertain language .... Cervical treatment should be mastered by slow processes."
Even before A. T. Stills death in 1917, it appears that the direct, thrusting techniques were slowly becoming more popular with osteopaths. In the 1920s, Still's influence waned as these techniques became, and remained, quite popular among the younger osteopaths. Some osteopaths remained true to the original methods, however, and criticized this new approach. Among them was J. B. McKee, D.O., who in 1979 warned that hearing a pop was no indication of correction.
"... the main danger [is the] confusion resulting from confounding the sound of articular separation with the correction of the existing lesion," wrote McKee."Even the veriest layman knows that he can pop his knuckle without any way changing the relation of the joint surfaces and it would be well perhaps if osteopaths would give the thought more consideration than seems to obtain at present."
These direct, thrusting techniques have remained the most popular mode of treatment among the majority of chiropractors. Among osteopaths, these techniques became increasingly popular until they were apparently the primary method of manipulation taught in osteopathic schools from the 1930s through the 1960s.Some reasons, I believe, are fairly obvious. The older osteopathic techniques require a highly developed sense of touch, focused concentration, and are slower to perform and very difficult to teach correctly. The direct, thrusting techniques on the other hand, are quick, efficient, and can be taught relatively easily to large classes of students.
Both the chiropractic and osteopathic professions have changed. Over the last century, osteopaths have fought for and have won full licensure in all 50 states and are able to prescribe medications as well as to perform surgery. Today doctors of osteopathy are found practicing in all specialties of medicine. Manipulation is still taught in every osteopathic school and many osteopaths continue to utilize these skills in their practices.
Today, however, not all osteopaths continue to use their manipulative skills on their patients. Nonetheless, there remains a strong core of osteopaths who maintain the highest proficiency in manipulative medicine. Although many expertly utilize the direct, thrusting techniques, the older styles of manipulation never completely disappeared. Today an increasing number of osteopaths are interested in learning, developing, and thus continuing this older, gentler style of manipulation, especially with the current renewed interest in natural medicine and the emphasis on assisting with the body's own power for healing. Some chiropractors are also now using more of the gentler techniques and methods of correction.
My explanation of all these techniques has been necessarily oversimplified. To perform any of these techniques requires a detailed knowledge of anatomy, palpatory and diagnostic skills, knowledge of indications and contraindications in the treatment of patients, and extensive formal instruction for safe, correct, and successful treatment. Most persons receiving manipulation therapy today are being treated with direct, thrusting techniques. When done intelligently and properly, these treatments are certainly beneficial, as many can attest.
The purpose of this article has been to explain why the Cayce readings made such a distinction between osteopathic and chiropractic treatments, to explain some therapeutic differences within these disciplines, and to suggest that from the readings, it may be realized that these gentler, indirect methods of manipulation first used by early osteopaths, and still in use today, are more in tune with the body's natural healing forces, and thus kindred in philosophy with health care as prescribed by Edgar Cayce. As reading 1158-24 put it:
"Then, the science of osteopathy is not merely the punching in a certain segment or the cracking of the bones, but it is the keeping of a balance - by the touch - between the sympathetic and cerebrospinal system!That is the real osteopathy!"
The founder of osteopathy, Dr. Andrew Taylor Still, was certainly an extraordinary individual, having started the first osteopathic college at the age of 64, after which he wrote four books.
In addition to his indefatigable stamina he was considered to have special powers of clairvoyance by those who knew him. He used this clairvoyant ability on occasion, as Edgar Cayce had, accurately diagnosing medical conditions of people in distant locations. He told one pupil, Dr. Ellen Ligon, that he could see a patient's aura and could tell from its appearance whether the patient was sick or well.
During one period of his life, Dr. Still regularly met with a local spiritualist group, and with a medium named Mrs. Allred, who supposedly channeled an Indian spirit named "Metah." Dr. Charles Teall wrote that "He was psychic to a degree and held communion with unseen powers who helped him over the rough road he was compelled to travel ."
In his Autobiography of A. T. Still, he stated, 'I was good at seeing visions all of my life.' Although these particular talents of Dr. Still were never emphasized, they provide a more profound understanding of the unique talents and insights of the founder of osteopathy.