The Philosophy and Mechanical Principles of Osteopathy by Andrew Taylor Still

This is considered the third book by A. T. Still, although it is very likely that many of its parts had been drafted in previous years.

Publisher: Kansas City, MO: Hudson-Kimberly Pub. Co.

Year of publication: 1902, first edition.

1986 – the volume was printed: Still A. T., The Philosophy and Mechanical Principles of Osteopathy. Reprinted, Kirksville, MO: Osteopathic Enterprise; 1986. Originally published, Kansas City, MO: Hudson-Kimberly Pub Co; 1902. Reprinted with the permission of Jerry L. Dickey, DO, President, Osteopathic Enterprise.

Number of pages: 336

The volume contains an introduction and 16 chapters, of which the content is briefly outlined below (the page numbers refer to the original edition in English).

  • In the introduction A.T. Still tells how he discovered osteopathy, highlighting the importance of knowing anatomy and maintaining that the osteopath must know how to reflect and reason. On page 12 we find the motto, often quoted: “The osteopath must re- member that his first lesson is anatomy, his last lesson is anatomy, and all his lessons are anatomy”.
    • The paragraph entitled “Man is triune” highlights how first, there is ” the material body; second, the spiritual being; third, a being of mind which is far superior to all vital motions and material forms, whose duty is to wisely manage this great engine of life.” (pp.16-17).
    • The definition of osteopathy recites as follow: “It is a scientific knowledge of anatomy and physiology in the hands of a person of intelligence and skill, who can apply that knowledge to the use of man when sick or wounded by strains, shocks, falls, or mechanical derangement or injury of any kind to the body. An up-to-date osteopath must have a masterful knowledge of anatomy and physiology.” (p.18).
    • A.T. Still saves some comments on the independence of osteopathy, which is different from the other systems, and to the importance of brevity.
  • Chapter 1: A.T. Still lists the relevant studies for an osteopath, namely anatomy, physiology, chemistry, the principles of osteopathy, symptomatology and surgery.
  • Chapter 2: A.T. Still provides interesting reflections about the various components of the body:
    • bones;
    • brain;
    • cerebrospinal fluid;
    • spinal cord, which may become inflamed if vertebral treatments are carried out more than once or twice a week;
    • nerves, which are “the children and associates of one mother – the heart.” In A.T. Still’s opinion, the physical heart is formed first, and within it the spiritual being establishes an office to supervise the construction of the organism pp.47-48;
    • nerves;
    • the blood corpuscles, which conserve a “biogenic life” also when they are diseased (p.52);
    • body fluids;
    • blood: one of the mysteries of animal life, of which we know so little that we are unable to produce even a drop of it (p.54). “The rule of artery and vein is universal in all living beings, and the osteopath must know that and abide by its rulings, or he will not succeed as a healer.” (p.55),
    • diseases, “an osteopath should be a clear-headed, sober, conscientious, truth-loving man” (p.57), who finds the cause of disease through reasoning;
    • the fascia, defined as one of the most important and mysterious parts present in all creatures (pp.60-61);
    • the lymphatic system, which is closely and universally connected to the spinal cord and to all the other nerves, and which, together with them, drinks from the cerebral fluids (p. 66). It is like a fire system with nozzles in all windows, ready to extinguish the flames (p.69).

The chapter ends with some considerations on treatment: “the word “treat” has but one meaning – that is, to know you are right, and do your work accordingly.” (p.69).

  • In chapter 3, A.T. Still affirms that, for educational purposes, it is good to divide the body into five parts in order to study it better, always highlighting how each part is interconnected to all the others, “like in a city”.
  • From chapter 4 to chapter 9 (pp. 77-224) A.T. Still, always reminding that the practitioner must keep well in mind the general principles of osteopathy, focuses on some individual body regions:
    • Head, face and scalp
    • Neck
    • Thorax
    • Diaphragm
    • Abdomen
    • Pelvis
  • Chapter 10 is about fevers, here A.T. Still reiterates that it is important to understand the cause of fever instead of meticulously examining the symptoms in order to find the name of the disease: the fever is only an effect (p. 235). The osteopath has to check the spine to ensure that it moves perfectly and that nothing interferes with the nervous and blood supply (p. 239).
  • Chapter 11, entitled “Biogen”, contains philosophical reflections on the eternal question: “what is life?”. A.T. Still affirms that “life and matter can be united, and that that union cannot continue with any hindrance to free and absolute motion” (p. 250), and “All material bodies have life terrestrial and all space has life, ethereal or spiritual life” (p. 251). These two lives unites to originate the human being, “Life terrestrial has motion and power; the celestial bodies have knowledge or wisdom. Biogen is the lives of the two in united action, that give motion and growth to all things” (p. 250). For additional in-depth analysis please refer, for example, to the book of Paul Lee,1 the short volume of Zachary Comeaux2 and to the article of Dominick Masiello.3
  • The last chapters contain miscellaneous topics: chapter 12 is dedicated to smallpox, measles and scarlet fever. Chapter 13 focuses on obesity and chapter 14 on ear wax. Chapter 15 talks about convulsions.
  • Chapter 16 is dedicated to obstetrics. Still highlights how the first obligation of the obstetrician is to examine the pelvis and the spine bones of the mother to ensure that everything is normal. If not, he or she will have to inform the patient of the risks and possibly refuse to follow the case. Pages 313-319 contain some practical instructions to avoid lacerations during childbirth, to tie the umbilical cord, on the expulsion of the placenta, mastitis and first care for the mother and child.

Strengths: an absolutely fundamental reading to understand the reasoning at the basis of the osteopathic philosophy directly from A.T. Still’s voice.

Weaknesses: the volume is written in A.T. Still’s characteristic style.

The precise dating of this volume, often referred to with the acronym PMPO, is controversial.
The following considerations have been presented in favor of the thesis maintaining that the book had been written in the years preceding 1902:

  • although the frontispiece of the book shows “1902” as year of publication, in the first pages of the book a copyright date appears, dating back to 1892;
  • according to Sutherland, the volume PMPO was written before the text Philosophy of Osteopathy, a fact considered important as in this book the mechanical aspects of the new discipline are highlighted;4
  • there is an autograph note by Still regarding the expected publication of a volume in June 1892;
  • according to Jerry Dickey, DO, the book was already completed in 1892 but Still might have not published it, perhaps fearing to provide excessive information to competitors.

On the other hand:

  • from the bibliographic research carried out at the Library of Congress there is no copyright dating 1892;
  • both Charles Hazzard and C.M.T. Hulett believed that the writing of the volume PMPO was closer to 1902, although the preface could date back to one or two years earlier;
  • in an article of 1901, Still himself refers the writing of two books (therefore it is supposed that he referred to the Autobiography, 1897, and to the Philosophy of osteopathy, 1899);

the JAOA announced in January 1903 that PMPO was ready for sale.
For further information please refer to the article of Jane Stark.4

Shortly after its publication Still tried to withdraw the volume from its free circulation in the market, sharing it only with a few people from then on, maybe because he thought that some of the ideas exposed were too controversial, or even not to disclose information deemed confidential. Only in 1896 the book was available to the general public again, thanks to an anastatic reprint authorized by Still’s family, in particular by his grandson C.E. Still Jr. and by Mary Jane Denslow, who owned an original copy.1

  1. Lee, R. P. (2005). Interface: Mechanisms of spirit in osteopathy. Stillness Press, LLC.
  2. Comeaux, Zachary (2009) The Soul of Osteopathy: The Place of Mind in Early Osteopathic Life Science. Booklocker.Com Inc.
  3. Masiello, D. J. (2022). AT Still’s Biogen. AAO Journal, 32(1), 37-43.
  4. Stark, J. E. (2012). Quoting AT Still with rigor: an historical and academic review. Journal of Osteopathic Medicine, 112(6), 366-373.

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