At the British School of Osteopathy in the early 1990s the founder of osteopathy was rarely mentioned. In our first year we received a one-hour lecture on Dr. Andrew
Taylor Still and, except for the occasional mention of his name or the repetition of one of his quotes, that was all we received for the remainder of the course. The
prevailing opinion was that Still was merely a historical figure whose teachings had been superseded by a more scientific attitude. This I found curious and it prompted
me to take out his Autobiography from the library. What I read amazed me with its depth of thought and insight.

It soon became clear that most of the school’s faculty harbored the same misunderstandings and prejudices about Still that had plagued him even during his
lifetime. Very few of my tutors and lecturers had actually read his writings and when I asked them to explain the philosophy of osteopathy, without exception they
reiterated the ‘four principles’ that appear in the osteopathic texts: the body is a unit; the body possesses self-regulatory mechanisms; structure and function are
reciprocally interrelated; rational treatment is based upon these principles. This, too, I found curious – did it mean that the philosophy and the principles were the same
thing? To me that did not make sense.

So I began to investigate the matter. My first surprise was to learn that the ‘four principles’ were introduced to the profession in 1953 by a committee in Kirksville –
and that they were not the principles taught by Dr. Still. This raised a serious question: if no one knew Still’s philosophy, and the principles being taught were not
his, what was I learning?

In 1997, two years after graduating, I travelled to Kirksville, Missouri, to research in more detail. I remained there for nearly five years and it took me a further decade to complete my biography, self-published in December 2012, A. T. Still: From the Dry Bone to the Living Man.

The more I studied the founder and his teachings the more I realized that this was one of the most important stories anyone could write, and that to do it justice I
needed to perfect the art of writing. It was not an easy story to compose either; it felt like trying to complete an impossibly difficult jigsaw puzzle without a picture, but the lengthy process of trying to fit the pieces together taught me the most valuable lesson: osteopathy was to Still primarily – even above a system of treatment – a
philosophy, one quite different to the one I grew up with and which took much mental adjustment to fully grasp. ‘Osteopathy is Nature,’ 1 he teaches.

A terrible personal tragedy began Still’s questioning of medical practice. He had been a doctor for ten years when, in February 1864, an outbreak of meningitis
claimed three of his children and an ‘adopted girl.’ As he languished in grief and disillusionment, however, he was struck a profound insight: ‘I decided then that God
was not a guessing God but a God of truth. And all His works, spiritual and material, are harmonious. His law of animal life is absolute. So wise a God had certainly
placed the remedy within the material house in which the spirit of life dwells.’ 2

For the next ten years he struggled with the knowledge that medicine knew neither the cause nor the cure of not only meningitis but disease generally, and that
the drugs he had been taught to prescribe were ineffective and possibly dangerous. He was aware that the medical definition of disease was altered physiology, but no one knew what caused the physiology to go awry in the first place. But his insight raised a fundamental question: if the body innately contains all the remedies needed for curing, what should be the role of the doctor? It inspired him to read extensively – not only medical books but also natural sciences and philosophy.

Philosophy – a subject that debated the relationship between God, man and nature – was the key. Since childhood Still had been indoctrinated with the Christian
notion of an omnipotent God and of man’s dominion over nature, but had entered medical practice on a Shawnee Indian reservation in Kansas where his preacher-
physician father had been sent as a missionary. Here he was exposed to a radically different attitude towards the natural world: the Indians taught that man was part of
nature, not its dominator, and that nature was pervaded by sacred wisdom.

On 22 June 1874, Still experienced a life-changing revelation; ‘that the works of God would prove His perfection.’ 3 His saw that nature constantly strives to express perfect health. How it does so remains a mystery even today, for it cannot be explained by any known scientific law. Medicine is based on science, but Still
reasoned that to find health rather than treat the symptoms of disease the practice needed to be guided by a different philosophy.

As Rudolf Virchow had noted in his Cellular Pathology – a book that Still treasured – materialism had limitations when applied to the living being. Unafraid to
challenge the norm Still adopted a new philosophy, one adapted from the English philosopher Herbert Spencer, whose thesis was a reconciliation of science and
religion. Still’s new philosophy – ‘the law of matter, mind and motion, blended by the wisdom of Deity’ 4 – could not only accommodate scientific knowledge but also mind
(a word that also encompasses the ‘wisdom of the body’) and life (a word Still used interchangeably with motion and spirit), without assuming (as did science) that they
somehow emanate from matter. This was a philosophy centered not upon the material but upon the immaterial – a spiritual philosophy.

The implications of its adoption were enormous. Firstly, it meant he could no longer venerate science as the ultimate arbiter of truth. It did mean he could still
value all verifiable scientific knowledge, but with the understanding that science can only glean facts about the ‘knowable’ part of nature, while acknowledging that the
unknowable part – nature’s drive to express health – is responsible for healing. Instead of looking to science for ultimate truth he would look to nature in its entirety,
both its material and immaterial aspects. Under this philosophy he could regard health as a spiritual quality – and this tenet forms the basis of all osteopathic
reasoning. Still constantly impressed upon his students that they must acknowledge that every cell of the living human body possesses infinitely more intelligence than
the rational thinking mind.

The philosophy and principles of osteopathy are not the same. The philosophy forms a foundation from which its principles of application derive, and the
fundamental principle (surprisingly absent from the ‘four principles’) is cause and effect. Medical diagnosis and treatment is physiological; osteopathic diagnosis and
treatment are anatomical. Still teaches that disease is the physiological effect of anatomical derangements (primary osteopathic lesions from trauma or strains or
secondary lesions manifesting in the structure from environmental or other influences). Normalizing deranged anatomy restores normal physiology because of
the complementary, spiritual, principle that nature constantly strives towards health. Every cell will maximize its potential for health only with an unimpeded blood
circulation, so the role of the doctor is to free the arteries and veins and their controlling nerves by normalizing the body structure, often in extremely small, subtle
ways. Find, fix it, and leave it alone. Nature will do the rest.

The same philosophy informs William Garner Sutherland’s approach, which is pure osteopathy in the true sense of the word. How this method of treatment works is
not fully understood, but the philosophy of matter, mind and motion allows us to acknowledge the limitations of our knowledge, learn to trust what we sense and feel,
and defer to nature’s greater wisdom. The interaction of patient and practitioner is complex and multifaceted. Science continues to elucidate more about the
electromagnetic nature of the body and our hands, practitioners are constantly learning how mental development is a powerful tool for enhancing treatment, and some are taking treatment into the realm of the spirit. To the founder all these things were integral aspects of nature and hence osteopathy.

Still was not introducing a manual therapy for a narrow range of musculoskeletal complaints. He was presenting a new paradigm for health, a new philosophy that can
be universally applied. We are not islands but parts of nature, parts of the whole, and nature’s laws are absolute and unchanging. ‘It is my hope and wish’, he wrote, ‘that
every osteopath will go on and on in search for scientific facts as they relate to the human mechanism and health, and to an ever-extended unfolding of Nature’s truths
and laws.’ 5 He teaches that nature’s truths and laws go beyond the physical. They encompass not only body’s anatomy, physiology and biochemistry in health and
disease but also the wisdom of the body, and on to life and death.

It is surely no coincidence that this philosophy bears close similarities to that of the North American Indians, since Still’s first patients were Shawnee. The Indians
saw no separation between God and nature, or matter and spirit.

The Native American view is ‘we are all related.’ Human beings have relationships with animals, insects, trees, plants, water, air, wind, the seasons, sun and sky, food,
medical drugs and all else – and our health and happiness are affected positively or negatively by everything we interact with. Similarly in the human ecosystem, a
microcosm of universal laws: every cell is in mutual dependence with every other; and the physiology of the whole organism is profoundly affected by thoughts,
emotions, foods, medical drugs, and myriad other things. Nothing is isolated. To recognize these interconnections is to start to understand osteopathy. And perhaps
we also need to the Indian teaching that if we do not acknowledge the relationships between things we do not feel the need to respect things.

When the trend in our profession is towards attaching to the names of schools and colleges the oxymoron ‘osteopathic medicine’ when evidence based medicine is the latest insistence of policy makers, when the Dutch association has decided to refuse accreditation to courses of osteopathy in the cranial field, many seem to regard Dr. Still as merely a historical figure and his teachings irrelevant. This is the ‘lesion’ in osteopathy, a result of a lack of knowledge about what the word osteopathy truly
signifies.

Many external pressures continually draw osteopathy away from its roots, while at the same time there is a lack of knowledge about the importance of those roots.
When we understand Still we see that the outcome of treatment is not dependent upon statistics but about developing our hands, minds and senses as sensitive
instruments. Every case is unique, complex and multifactorial, and we must have the knowledge, skill and art to remove the precise cause of the problem – in matter, mind or motion.

In Dr Still’s philosophy lies the inspiration, the strength and the profession’s uniting power. And the truth. Still’s teachings are timeless, for they are not based on the
shifting sands of scientific knowledge and trends but on the immutable wisdom of nature. Osteopathy has always been a square peg in a round hole and, now as in
Still’s day, those who seek to round off the corners to make it acceptable to the dominant system merely serve to dilute the pure osteopathic teachings, restrain the
potential of students, and limit the perceived scope of osteopathy. This is good for no one.

The osteopathic profession would be stronger if students were taught the founder’s pure teachings, for they are as relevant now as they were to the first students of the American School of Osteopathy. Nature never changes. Dr. Still is the profession’s greatest asset, if only we listen to what he has to teach.

© John Lewis 2013.

1 Journal of Osteopathy, December 1894, 1.
2 A. T. Still. Autobiography. American Academy of Osteopathy, Indianapolis. 1994. Reprint of revised (1908) edition. p87-8.
3 A. T. Still. Autobiography. p258.
4 A. T. Still. Autobiography. p250.
5 A. T. Still. Osteopathy: Research and Practice. 1992. Eastland Press, Seattle.