7. Andrew Taylor Still founds the first school of Osteopathy

The first course began in the autumn of 1892 with a dozen students, joined by a similar number of other students in the following months. At eight in the morning, in a classroom of twenty square meters, the students attended Smith’s anatomy lessons and then at nine o’ clock were admitted to the clinic to observe Still, his children and other practitioners while they were treating patients in the ten rooms set up especially for the purpose (Gevitz 2014b; Trowbridge 1991:145).

The minutes of a meeting of the ASO Board of Directors, dated November 1, 1892, report the assignment of the position of Professor of Surgery and Obstetrics to Dr Andrew P. Davis, who had enrolled in the first course of the ASO (Gevitz 2014b:116). Davis owned a degree in Allopathic and Homeopathic Medicine as well as being an avid scholar of several other forms of therapy, including hypnotism. He left Kirksville after graduating and continued his research that led him to delve into chiropractic. He published several books, including a work on osteopathy (Osteopathy Illustrated: a drugless system of healing), and opened several training schools. There remains no trace of his possible activity as a teacher at the ASO.

Several photos kept at the Museum of Osteopathic Medicine (eg, Catalog Numbers: 1975.95.30.01; 1976.186.01; 2008.33.312) portray students and professors of the first course, often together with the American flag and a human skeleton, affectionately called Columbus or Mike, which was the only equipment in the anatomy room. The first class included five children of Still (Charles, Herman, Harry, Fred, Blanche) and his brother Edward. The school was also open to women, who paid $200 tuition while the fee for boys was $500 (Walter 1982:7). On February 15, 1893, Still wrote the first certificate, issued to William Smith, who left Kirksville with the title of “osteopathy graduate” to open a studio in Kansas City (Lewis 2012:146).

Still decided to give graduates the qualification of “graduate” (later changed to “doctor”), perhaps to avoid problems with the medical class, or more likely to emphasize how his method was different from the traditional practice of medicine (Walter 1982:7; Gevitz 2014b:117).

Meanwhile, the Health Commission of the State of Missouri was working on a law that, if promulgated, would have allowed the exercise of the medical profession exclusively to graduates of allopathic, homeopathic and eclectic schools. To prevent its approval, Still’s supporters launched a petition and collected five thousand signatures. Also on January 13, 1893, before the notary W.T. Porter, three graduates in Orthodox medicine – William Smith, Andrew Davis and the latter’s son – signed a declaration solemnly and sincerely swearing that osteopathy produced progress in the therapeutic sciences (Still 1897:366).

The discussion took place on February 14 and the bill was rejected by 88 votes against 34. Although the ASO was safe, Still was not satisfied with his students: he believed to have churned out “imitators” with limited knowledge of anatomy and that he had failed to convey the philosophy behind the osteopathic science, which was based on reasoning (Walter 1982:7). In the summer of 1893 Still came to think of closing the school. According to Still, the medical graduates who had attended the course had simply added osteopathy to their paraphernalia of pharmacological care, an idea completely contrary to his theories. This prompted him to introduce a general rule, later revoked in 1897, whereby the ASO would not admit those who had previously studied medicine (Walter 1982:11-12; Gevitz 2014b:117).

Serious disagreements emerged with Marcus Ward, who refused to attend his sophomore year, opened a practice in Kansa City and tried to discredit Still; in the fall he returned to Kirksville and opened a clinic offering medicated baths.

From May to October 1893, the Columbian Exhibition was held in Chicago, which attracted 27 million visitors. Dr. Still was one of them, together with his wife and son Charles, who on his way back stopped in Red Wing, Minnesota, where he opened a practice at the invitation of Senator Peter Nelson. When he had a difficult case in November, he sent for his father, who administered a treatment, freeing the patient from pain. Before leaving,  A.T. Still was taken on a tour of the city in a buggy and, observing the numerous quarantine warnings resulting from the diphtheria epidemic, asked why they had not asked Charles to handle the cases. Apparently, no one knew osteopathy could be useful. Still had noticed that the disease caused stiffening of the muscles from the neck to the diaphragm, resulting in stagnation of fluids and production of bacteria, so he asked Charles to reason on that basis to administer the treatments with which he solved over sixty cases. The death of a child at whose bedside Charles failed to arrive in time resulted in a complaint and arrest for practicing medicine without a license. Senator Nelson had Charles released, and local people were present at the trial in court in such a large and enthusiastic number that the other side withdrew the complaint (Lewis 2012:150-51).

In October 1892 and April 1893, two St. Louis newspapers dedicated some space to osteopathy and described it favorably (Walter 1982:11). Despite Still’s uncertainties about the opportunity to continue the teaching activities, the ASO courses resumed in the fall of 1893 and the number of students rose to about thirty: some Kirksville citizens also enrolled. They gave up their careers to study the new science, like the post office director Edward Pickler and real estate agent Henry E. Patterson, who would later become school secretary. His wife Alice Patterson, after graduating in 1895, would work in the clinic as a practitioner (Hildreth 1938:41).

After Smith’s departure, the chair of anatomy was given to Jeanette Hubbard Bolles, who held a degree in humanities awaered by the University of Kansas in 1885. The course of study was extended to two years (five months each) and access to the clinic was forbidden to students who had not demonstrated knowledge of the anatomy of legs and arms (Gevitz 2014b:118).

On March 4, 1894, a banquet was organized for the students who had completed the first two years of study. Amid speeches and toasts, the problem of legal recognition in the state of Missouri emerged: the current law recognized only graduates of traditional schools (orthodox, eclectic, homeopathic) and everyone present was encouraged to strive in order to change it.

On June 8, Fred, the youngest and most studious of Still’s children, considered the rising star of osteopathy, died at the early age of twenty, surrounded by his family members – he had not recovered from serious injuries following an accident: During the previous autumn, a horse crushed him against a wall in the stable, fractured his rib and punctured his lung. The boy, finding himself in weak conditions, had contracted the turbercolosi (Lewis 2012:171; Trowbridge 1991:147).

The great amount of patients and students who flocked to the clinic and school brought a significant positive impact on the welfare of the town of Kirksville, and during this time rumors spread that the ASO was going to be moved to a larger city. The residents, fearing to lose such a great source of income, ran for cover and on June 2 some delegates offered the proceeds of a collection (2,550 dollars) and some building land to A.T. Still. Nevertheless, he had already decided to remain in Kirksville and under no circumstance would accept any contributions from others: it was his expressed desire to build the clinic and the school on his own land by the only mean of his own money – he believed it was the only way to keep control of the project. So he entrusted Thomas, the son of his brother Edward, with the task of erecting a brick building (Lewis 2012:170-171).

When A. T. Still opened the school of osteopathy, in 1892, he was 64 but still at his best and looked younger than his age. For his physical appearance he was often compared to Abraham Lincoln: almost 6-feet tall, with an olive complexion, black hair and gray piercing eyes, a charismatic presence altogether. He had big hands, an aquiline nose and a wide forehead. His skull was somehow asymmetric, as illustrated by the osteogram drawn by Charlotte Weaver. His gait was quiet like that of the Indians, as some would say. He walked with a slight forward tilt of the body, supporting his weight with the forefoot at each “bouncing” step.

He spoke softly, giving the impression that his words “came from far away”. He was also a good orator, capable to induce a feeling of intimacy in those who listened. He had no interest for pleasantries or elegant clothes and did not like banquets or social life. He hated alcohol, drugs and the dangerous medicines of the time, although he had a sweet tooth and chew tobacco.

He had a sharp sense of humor and enjoyed joking around. Money was of no interest to him except as a means of helping others. He often buzzed around the ASO offices, hoping to get his hands on small sums of money to give to those he thought needed them. Fame and wealth did not change his simplicity nor the benevolence and empathy he felt for the whole mankind. He remained always the same doctor, philosopher, teacher and friend that he had always been in times of adversity (Booth 1924: 459, Hazzard 1918). He detested lies, hypocrisy, falsehood and laziness, was a kind and very generous man, deeply patriotic and a prohibitionist – he was unselfish, with democratic ideas and a great love of truth.

He used to get up at dawn and often work sixteen hours a day, focusing on his study, experiments and demonstrations. In addition to anatomy, which he knew perfectly, he had an interest in astronomy, mineralogy and ornithology. He was fascinated by animals’ organisms, perfect as the humans’ one, and collected stuffed animals, many of which were displayed in the school.

He was capable of carrying out any work needed to run a farm, while also being a skilled mechanic. He always remained faithful to his roots as a border’s settler – sometimes, even in old age, he would kill a deer, keep its meat for consumption and tanned its skin, from which he then obtained loafers or rudimentary garments for himself or other family members.

He always had a very clear goal, that is developing osteopathy, to which he devoted all his energies with admirable tenacity. His greatest desire was for everyone to understand his vision and the importance of anatomy. He was not discouraged by the injuries suffered during the Civil War nor by the ouster from “good society”, set up by the Methodist ministers. He always had a lot of understanding for his enemies and also for the  physicians, of which he blamed none, believing that they were acting out of mere ignorance (Booth 1924:459). He never felt like a martyr nor allowed anyone to put him on a pedestal because of the difficulties he had faced; he actually told his son-in-law that he had had fun standing up to his opponents, drawing much more satisfaction out of it than people would ever imagine (Laughlin 1923).

He was extremely democratic: he had nothing to say to those who approached him with a sense of superiority or presumption, while in the same way he did not appreciate when students greeted him by touching his hat in sign of respect. He never forgot all those who had known and helped him before his final success – he would often visit them for the pleasure of being in their company and treat them for free if they got sick and would also frequently give them money as a tangible sign of his gratitude (Booth 1924).

In his lectures, Dr. A. T. Still tried to convey his way of reasoning and his philosophy to the students, without focusing on individual osteopathic techniques – he did not wish to be slavishly copied but wanted each student to become an independent thinker, developing the ability to interpret the signs and find the best ways of care for each case. Furthermore, he used to repeat that “An intelligent head will soon learn that a soft hand and a gentle move is the hand and head that get the desired results” (Booth 1905: 40).

He expressed himself with an inspired language, often resorting to parables of not easy interpretation. However, with his charisma he was able to convey  the simplicity and beauty of his vision to those who listened, based on philosophical ideas but also pragmatic ones, always open to future developments. He often likened Osteopathy to a squirrel in a hole in a tree. He would say that he had succeeded in getting the tail out, and it was necessary for others to extricate the body from its hiding-place. (Booth 1905:63).

He was always in search of the truth and ready to recognize it wherever it was, and he had little interest in wasting time arguing with anyone who did not understand his theories or tried to ridicule him. For him, freedom of thought and action and the very freedom to teach and to hold his own ideas were paramount– he had little respect for orthodoxies and preconceptions, he despised disloyalty and betrayal.

He tried to convey to his students the wonder of the human body, emphasizing the importance of anatomy, physiology, diagnosis and therapy, as well as osteopathic principles such as the rule of the artery and the relationship between structure and function. He always carried a few bones with him to study them, and in each of them he saw the expression of the Great Architect’s work, before which he stood in reverent admiration (Gaddis 1929).

No textbooks were provided for his lectures, nor did he allow students to take notes. He recommended that they study the “book of nature”, while leaving them free to read all the volumes they wanted as long as they did so by exercising their critical thinking.

This is how Arthur Hildreth recalls a lecture that impressed him deeply, given by A.T. Still during the second course at the ASO: while he was explaining to the students the power of that magnificent law by which nature could cure diseases when the right conditions are created in order for it do so, Still suddenly stopped talking and left the classroom, saying that he would be back shortly. He returned a few minutes later bringing with him a stuffed bird with magnificent plumage in the shades of brown, bronze and white. As the students admired the bird, the Old Doctor pointed out its perfection, which could only be maintained by the natural law of supply and demand within its body – its beauty would be preserved as long as the nerves and circulation continued their function. Without any physical interference, each grain of food eaten carried the building materials necessary to maintain its beauty, and the same magnificent law was at work within the human body (Hildreth 1938:43).

With the exponential growth of the school, Dr. AT Still employed many teachers expert in both basic sciences and medicine, but often lacking in osteopathic training. Therefore some of these new professors, while teaching their own subjects at the school, followed the courses of osteopathy to obtain the diploma of osteopathy. Dr. A. T. Still had the habit of silently sneaking into the classrooms and sometimes intervening to make corrections, or to take the place of the teacher in order to clarify a concept. He recalls how once he interjected to argue that there was no reason to remove one’s tonsils, since God had intended them to exist and He must have had some good reasons for it (Lewis 2012). Another time resumed Dr. William Smith, who had raved about an anatomical description of the quadratus lumborum muscle and had not explained that, if contracted, he could drag down the twelfth rib – dr. A. T. Still believed it important to always adopt an osteopathic perspective (Willard 1954:23).