A nine-year-old boy with wonky teeth
Ricerca e scienza
di Richard Douglas, edited by Maximilien Girardin
A.T Still’s:
The Philosophy and Mechanical Principles of Osteopathy
1902. Kansas City, MO
In the case of a nine-year-old boy with wonky teeth.
Part I. The Philosophy.
Part II. The Mechanical Principles.
Richard Douglas D.O. BSc. (hons) Ost.
Synopsis
Part I. The Philosophy.
This article is based on a nine-year-old boy with wonky teeth, who I had the pleasure of meeting in 2011. His mother asked me if I could help her son, as a dental assistant she knew that her son would need intensive orthodontic treatment to correct the situation. The process I went through and the spectacular results that were achieved were unfortunately the result of a conscious decision to discard the standard osteopathic testing and techniques that I have been taught. Even during my osteopathic training osteopathy wasn’t making any sense to me because even though I was failing exams, I was having good results treating real patients.
Modern osteopathy itself has no clear idea of what osteopathy is, this article takes a look at the definitions offered by five osteopathic organisations from all over the world such as in the USA, Canada, U.K. and Australia. These five definitions are different and they are confusing because there are three different versions to describe an osteopath and osteopathy (OMM, OMT, OMP).
Between 2011 and 2016 I struggled to find any logical explanation for the results achieved until in 2016, by chance I came across a book that I had left on my bookshelf for more than fourteen years. I first read it before I started my osteopathic training in 2002 but didn’t understand it. The book that I found again in 2016 was ‘the Philosophy and mechanical Principles of osteopathy by A.T. Still.’ I read it again and again and still I didn’t understand it. I kept at it and now It is clear that modern osteopathy bears no resemblance to the osteopathy that Still ‘discovered’. After many hours, days and months of comparing the definitions of the words we use today with the definitions in the ‘1828 Noah Websters American Dictionary of the English language’, it became obvious to me that the words we use today did not mean the same in the 1800’s.
What we think we are reading, is not what was written.
I have held Still’s work up to the inspection light of ‘wonky teeth’, if Still’s work is of any use to us in our daily practice then it will stand up to scrutiny, it will be applicable and it will make sense.
If we cannot use it, what was the point of him writing it? However, if we have never studied in depth what he wrote, how can we ever use it? If our teaching institutions don’t teach it, how can we ever learn it?
This article will be written person to person and not as a third person to nobody.
1. Introduction
This article is inspired by the growing number of osteopaths who are beginning to realize that there is something fundamentally wrong with the way osteopathy is being taught in our schools of osteopathy.
The article It is based on my experience in 2011 of treating a nine-year-old boy with wonky teeth and my conscious decision to ignore everything I had been taught to allow my own knowledge and experience to guide my intuition. The obvious but unexpected changes you will see, occurred in just a few weeks. The very fact that these changes where ‘unexpected’ is in itself an indication that the osteopathic training I received is inadequate when called upon to explain this situation. These photos will be discussed in detail later. However, the global changes you see are obvious even to any untrained eye. No documented osteopathic testing or treatment techniques were used and there were no orthodontic interventions. This begs the question “is this osteopathy?”
Fig.1 Pre and Post intervention photos from June 2011 and November 2011
Even during my osteopathic training, osteopathy wasn’t making any sense to me, I freely admit to failing most of my exams at least once and having to re-sit exams time and time again. On the one hand I was failing my exams but on the other hand I was having good result during clinical practice treating real patients. For me osteopathy is about using your knowledge to help people and that’s what I tried to do. One of the teachers in charge of the clinical practice didn’t appreciate my attempts to help my patient, she told me “stop inventing osteopathy and just do the techniques you’ve been taught”. Even after graduation, during a post-graduate paediatric course that I took, again I failed my exam and again I failed in clinical practice. After treating a child, the teacher gave me a low score and commented that I was “interfering with the child’s system.” Sometime after, the director of the institute came up to me to pass on a compliment that he had received from the mother of a child who I had had treated in clinical practice. The child had said to her “That one osteopath really understood me”. Just to be sure I asked him, “Do you mean the child whose system I was apparently interfering with?”. He confirmed that it was the same child, and I never bothered completing the course.
From starting my osteopathic training in 2002 up until the treatment of nine-year-old boy with wonky teeth in 2011 I was left asking myself;
“why is what I’m doing, not representing what I’ve been taught?”
“Is what I’m doing osteopathy or, is what I’m not doing osteopathy?”
Armed with photographic evidence I was convinced that what I was doing was osteopathy and I showed the photo’s to various colleagues thinking that I could finally show people what “real” osteopathy is. I soon realized that I had no foundation for what I was saying because I found myself having to answer question like; “which techniques did you use”, “Where did you do the course on orthodontics?” and worst of all “how many teeth did you treat per session?”. Because I myself had no foundation to reason on, I found myself being lectured to by colleagues who were happy to give me an explanation of these events, but when I ask them if they have also had the similar results, they decline and say “No It’s just my theory”.
My osteopathic hart was going into cardiac arrest because these questions and theories do not arise from a lack of intelligence but are a consequence of the way we think, and the way we think is in turn a consequence of HOW we are taught, not WHAT we are taught. I filed the photo’s under “D” for ‘Done that,’ to the back of my mind and just went back to doing what I do, hoping that it is somehow representing what osteopathy is supposed to be.
By chance in 2016 whilst looking for something in my book case, A.T Stills ‘The Philosophy and Mechanical Principles of Osteopathy” from 1902 fell out onto the floor, I picked it up and put it back in the book case. A while later I couldn’t resist the urge to read it again. Having read the book before I started my training in 2002, I didn’t understand a word the guy was writing about. But somehow, I knew that what he was trying to tell me must be important, why? Simply because he took the time and trouble to write it. I started reading it again, it is very hard but the fact that I knew that this must be important work gave me the motivation to keep at it and eventually, I began to make some connections.
This article isn’t an ode to Still and I do not pretend to be an expert on Still and his writings.
I do not know him and I do not claim to be a better osteopath than anyone else.
But If we say we are osteopaths then we have made a conscious decision to agree with the principles and philosophy of osteopathy.
We must therefore also agree that A.T.Still is the only person we can look to for advise on the basic foundation on which osteopathy stands.
Why?
Because he was the one, that not only laid the foundations, but he was the one that chose the plot of land, surveyed the ground and dug out the site on which these osteopathic foundations lie.
Only by studying his work in depth, can we have any idea of how these foundations were laid.
That is essentially important if we have any hope of extending and maintaining a solid and stable osteopathic house.
However, during my six years of osteopathic training and ten years of practice, I have never received any formal in-depth teaching based on Still’s own work.
Modern osteopathy seems to have lost touch with these stable foundations and has decided to move to a new location and build a new house without surveying the ground on which it stands.
How long will it take before this new version of osteopathy comes crashing down around us because its foundations are weak and the ground on which it stands is unstable.
This historical move has been documented by Jane Stark D.O. , Evost Fellow in her article ‘An historical perspective on principles of osteopathy’. With respect to Jane I would say that even though I cite her work, I do not presume she in turn, agrees with anything I write.
“The modern period begins in 1953 with the publishing of The Osteopathic Concept and continues for 50 more years. This period is characterized by group efforts at principle development and reflections upon former principles, as well as consensus on the development and adaptation of principles for use within the field of osteopathic medicine in the United States. The set of osteopathic principles that has endured the longest was reworked and reworded by a committee of individuals, primarily osteopathic physicians. This committee worked from a previous document that was also formed by a consensus of mostly osteopathic physicians.” Jane Stark D.O. DOI: https://doi.org/10.1016/j.ijosm.2012.10.001
My article discusses the photographic evidence gathered in 2011, supported by recent evidence gathered in 2018 and tests the application of the modern definitions and principles of osteopathy in this case. I will not give any descriptions of methods or techniques used, I will only challenge you to dig deep into everything that you have been taught to find any reasons for the process that lead to these changes you see. If this is osteopathy, the definitions and principles we have been taught must apply in this case. The article will then test the application of Still’s work in this case. If what he writes is of any use to us in our daily practice, then we should be able to use his work.
Please forgive any ignorations, because as I have already mentioned, I have never been offered any formal teachings on Still’s work and have therefore had to spend hours, months and years on my own trying to fathom out what these works mean and more importantly, how can I use them in practice.
Please do not think that I just decided to read his book on a Sunday afternoon and now I’m claiming that I know everything about Still’s work.
In this article I will not quote Still’s work by re-writing his words, I will simply show then as written to avoid any confusion. I will not refer to any page numbers from where these extracts are taken, they are after all taken from the ‘whole’ the book that is titled “The Philosophy and mechanical principles of osteopathy” released in 1902. After weighing up the numerous contradictions and arguments about the date of this book, I have reason to believe that the 1902 version is actually based on his original writings from circa 1892. I will allow you to make up your own mind to agree or disagree. The reason I am writing this article is simply because I’ve been asked to do so.
2. Is this Osteopathy?
Osteopathy is begging to be recognized and respected by medical and scientific institutions. However, osteopathy itself has no clear idea of what osteopathy is. I recently looked at the definitions of osteopathy offered by certain osteopathic institutions in the U.S.A, Canada, Great Britain and Australia, clearly there is no consensus as to what osteopathy is. How can we command any recognition or respect, if we ourselves cannot agree on what osteopathy is? When we ask a simple question “is this osteopathy?” we expect a simple answer. If we agree that this is osteopathy then we must know why it is osteopathy and if we disagree, we must also know why it isn’t osteopathy.
Still offers his own definition of osteopathy but when asked, nobody seems to know what it is.
How can we say that we are osteopaths if we don’t even know what osteopathy is, according to the person who surveyed the ground and laid the foundations on which we stand? Why don’t we know this?
Question: According to the modern definition of osteopathy, is this osteopathy?
Look carefully, what do you see?
Can you determine just by looking at these photos if this is osteopathy?
What is causing this and what has changed?
Everything you need to know is in the photos, it’s there to see.
In order to know the answer to these questions we must know what the definitions and principles are.
Have you ever stopped to think how hard it is to answer the simple questions, ‘what is osteopathy?’ Osteopathic institutions across the USA, Canada, U.K and Australia have differing definitions. I offer a few of their definitions and invite you to find some way of applying these in the case of a nine-year-old boy with wonky teeth.
3. Osteopathy Defined
This section takes a look at five definitions of osteopathy that are offered to us by leading institutes and governing bodies of osteopathy on their websites.
AACOM (USA)
(American Association of Colleges of Osteopathic medicine)
“Osteopathic medicine provides all of the benefits of modern medicine including prescription drugs, surgery, and the use of technology to diagnose disease and evaluate injury. It also offers the added benefit of hands-on diagnosis and treatment through a system of treatment known as osteopathic manipulative medicine. Osteopathic medicine emphasizes helping each person achieve a high level of wellness by focusing on health promotion and disease prevention”.
AOA (USA)
(American Osteopathic Association)
“Osteopathic Manipulative Treatment, or OMT, is a set of hands-on techniques used by osteopathic physicians (DOs) to diagnose, treat, and prevent illness or injury. Using OMT, a DO moves a patient’s muscles and joints using techniques that include stretching, gentle pressure and resistance,”
I ask the following;
– Was the treatment based on the use of drugs? No
– Was any surgery performed? No
– Is the boy injured or sick? Are the teeth and gums diseased? If untreated would the boy’s health be at risk?
– Which muscles and which joints would need gently stretching and where would you apply gentle pressure to achieve the documented changes?
GOC (U.K)
General Osteopathic Council.
“Osteopathy is a system of diagnosis and treatment for a wide range of medical conditions. It works with the structure and function of the body, and is based on the principle that the well-being of an individual depends on the skeleton, muscles, ligaments and connective tissues functioning smoothly together.”
– Is this a medical condition? No
– Has the structure and function of the teeth changed? (discussed in Part II)
The Osteopathy Organisation (AUS)
“Osteopathy is a form of manual healthcare which recognizes the important link between the structure of the body and the way it functions. Osteopaths focus on how the skeleton, joints, muscles, nerves, circulation, connective tissue and internal organs function as a holistic unit. Using skilled evaluation, diagnosis and a wide range of hands-on techniques, osteopaths may identify important types of dysfunction in your body. Osteopathic treatment uses techniques such as stretching and massage for general treatment of the soft tissues (muscles, tendons and ligaments) along with mobilisation of specific joints and soft tissues.”
– What are Still’s thoughts on massage?
– How often did Still refer to techniques?
– What is a holistic unit?
CCO (CAN)
Canadian College of Osteopathy.
“A natural medicine which aims to restore function in the body by treating the causes of pain and imbalance. To achieve this goal the Osteopathic Manual Practitioner relies on the quality and finesse of his/her palpation and works with the position, mobility and quality of the tissues.”
– Does Still ask us to rely on our palpation?
These five definitions from organizations all over the world are clearly different. They are confusing because there are three different versions to describe an osteopath and osteopathy (OMM, OMT, OMP). Techniques such as stretching muscles and mobilizing joints have been around for thousands of years and doesn’t make osteopathy unique as Still suggests (see later). The Canadian definition is however useful when it refers to “causes of pain and imbalance” and the reference to “the quality of the tissues.” This gives a possible indication that this case might be osteopathy.
For example, we could ask;
– Are there any signs of imbalance?
– If there are signs of imbalance would we expect changes in the quality of the tissues?
4. Principles of Osteopathy
When you look at the websites of our osteopathic teaching institutions, we find the following list of osteopathic principles that we must agree to in order to receive our D.O. (diploma osteopathy). However, I cannot find a reference to any of these principles in Stills book. How strange is that? In a book titled “the Philosophy and Mechanical Principles of Osteopathy”, there are no references to these principles. Do you really agree with these principles? I was told I had to otherwise I would fail my exam, and of course I did fail my exam on the principles of osteopathy because they make no sense. If they do make sense, how can we apply them in practice?
How do they help me, help my patient? How do these principles explain the cause and effect of the problem and the changes that have occurred? These modern principles are as Jane Stark D.O. suggest, the result of “rewording” and in my opinion has had a disastrous effect on the way we think and therefore has a knock-on effect on what we do. I will come back to this point In Part II. For now, these are the principles that to me, make no sense.
- The body is a unit, and the person represents a combination of body, mind and spirit.
- Structure and function are reciprocally interrelated.
- The body is capable of self-regulation, self-healing and health maintenance.
- Rational treatment is based on an understanding of these principles: body unity, self-regulation, and the interrelationship of structure and function.
http://www.kcumb.edu/about-kcu/why-kcu/what-is-osteopathic-medicine/osteopathic-principles
How can I use these principles to explain this case?
5. Osteopathy According to Still
At this point it would be too easy to copy-paste Still’s own definition of osteopathy, but that would be a sadly missed opportunity.
The point of this article is to cause a spark that will light a fire of curiosity in you.
(Wake up the philosopher, note of editor )
It would however be very mean to leave you with no direction of where I’m going with this. We will look at his definition in relation to this case later on.
Thanks to colleague Max Girardin D.O. (EVOST Fellow) I will pass on the advice he gave me.
He said “when you go on a journey in dangerous and unfamiliar places, walk slowly and carry a big stick”.
When you journey into the danger zone of Still’s work, you need a big stick to defend yourself and that big stick is a dictionary, but not the one we use today.
The definitions of words that Still used more than one hundred years ago are not the same as today, we have no idea what these words meant to him because they mean something totally different to us.
For example, the very first noun used by Still is the word ‘philosophy.’ What does this word mean to us in 2019 and what did it mean to Still in 1892?
If you go online and look up the word ‘philosophy’ you will find numerous definitions and you can compare these definition with the one in the dictionary of choice in America in the 1800’s , Noah Websters American dictionary of the English Language 1828. It is freely available online (http://webstersdictionary1828.com) For example, compare the definition of ‘Philosophy’ today in 2019 and in 1829;
Philosophy (noun) (2019)
– The study of the fundamental nature of knowledge, reality, and existence, especially when considered as an academic discipline.
– (count noun) A particular system of philosophical thought. ‘the philosophies of Plato and Aristotle’
– The study of the theoretical basis of a particular branch of knowledge or experience.‘the philosophy of science’
– Theory or attitude that acts as a guiding principle for behavior.‘don’t expect anything and you won’t be disappointed, that’s my philosophy’
https://en.oxforddictionaries.com/definition/philosophy
PHILOS’OPHY, (1829) noun [Latin philosophia; Gr. love, to love, and wisdom.]
- Literally, the love of wisdom. But in modern acceptation, philosophy is a general term denoting an explanation of the reasons of things; or an investigation of the causes of all phenomena both of mind and of matter.
When applied to any particular department of knowledge, it denotes the collection of general laws or principles under which all the subordinate phenomena or facts relating to that subject, are comprehended. Thus, that branch of philosophy which treats of God, etc. is called theology; that which treats of nature, is called physics or natural philosophy; that which treats of man is called logic and ethics, or moral philosophy; that which treats of the mind is called intellectual or mental philosophy or metaphysics.
The objects of philosophy are to ascertain facts or truth, and the causes of things or their phenomena; to enlarge our views of God and his works, and to render our knowledge of both practically useful and subservient to human happiness. True religion and true philosophy must ultimately arrive at the same principle.
2. Hypothesis or system on which natural effects are explained.We shall in vain interpret their words by the notions of our philosophy and the doctrines in our schools.
3. Reasoning; argumentation.
4. Course of sciences read in the schools.
It is not the intention of this article to discuss all these words and definition, I only wish to point out that the if you choose to go on this “dangerous and unfamiliar journey” be aware, the words you read in the extracts I give, do not mean what you may think they mean. To form an opinion of what I write, you must know what these words meant in 1892. There is a notable difference, in our times the keywords in the definition of philosophy are fundament, system, theory and behaviour. In Stills time the keywords are wisdom, reasoning, causes of phenomena, religion and philosophy. That means, before we even open ‘The philosophy and mechanical principles of osteopathy’ the title alone puts us on the wrong foot, meaning that we head in the wrong direction before we read our first words, so just as the proverb says;
A journey of a thousand miles begins with a single step.
We would then have to add;
But if the first step we take is in the wrong direction, we then end up a thousand miles out of our way.
6. Osteopathy is apparently scared of the word ‘science’:
One thing missing from all these modern definitions of osteopathy is the reference to science. Still clearly states it many times, so why are our institutions seemingly scared of using the word science in their definitions? In Still’s definition of osteopathy, it’s the very first thing he mentions, how strange is that? The very first thing he mentions is the one thing we now avoid. The rest of his definition will be discussed later.
Because we have already established that words in his time probably don’t mean the same as they do in our time, we may also assume that the same is true for the word ‘science’.
What does it really mean and where does it come from?
When you go on a journey in dangerous and unfamiliar places, you usually come across obstacles that seem impossible to pass. You then have a choice either to go on, or turn around and go back. This is one word is such an obstacle, if we really want to understand wonky teeth, we must get over this obstacle, or turn around and go back to the modern osteopathy that we know, it will be hard but it will be worth the effort, that I can promise you.
After the title of the book, the next page on which he writes;
Was Still justified in using the word science or do we have no understanding of the word and what it really meant to him in his day?
Have we let scientist hijack the word for their own use?
There is no patent or copy-write on the word science.
Have scientists pinched the ball and won’t let anyone else play?
We often hear, ‘osteopathy isn’t ‘scientifically proven’, but what is science and what did it mean in 1829?
The word ‘science’, like many words originates from Latin and if we look its basic elements, we see two parts ‘SCI’ and ‘ENCE’.
SCIO = to know, to learn, gain knowledge,
ENCE = action, state of, quality of
‘Science’ simply refers to the ‘action’, ‘state ‘and ‘quality’ of the ‘knowledge’ thatwe ‘gather’ and ‘learn’.
It does not state in any way, that knowledge can only be gathered by using science experiment. If we look at the basic principle of science, I think we can agree that this would be an acceptable description,
This general description is an old a widely accepted version of the ‘scientific method’ I would like to point out that this is an old text that has been translated and re-written numerous times so I air on the side of caution on the exact definition.
However, I think we can all agree that this adequately describes the basic principle of science, but where does it come from and what is the point of the scientific method and more importantly who wrote it?
Before we go any further, I would like to make it clear.
I AM NOT SUGGESTING THAT STILL BASED HIS WORK ON NEWTON !!!
What I am pointing out is that the scientific method, is actually part of something else. This scientific method actually forms the “rules for the study of…. What?
Scientist have taken the scientific method out of its true environment.
We have allowed science to take the filling out of the cake and throw away the crust.
What is the crust of science, where does science belong?
The scientific method belongs to natural philosophy however, scientists have taken the scientific method out of philosophy and done away with the philosophy.
We have fallen into line and we also say ‘science’ and ‘philosophy’ but in fact they are inseparable. Science is the structure and philosophy is the function, together they are one. The scientific method is simply a means of gathering information in order to give; (1892 definition philosophy)
“explanation of the reasons of things; or an investigation of the causes of all phenomena both of mind and of matter”.
“The objects of philosophy are to ascertain facts or truth, and the causes of things or their phenomena; to enlarge our views of God and his works, and to render our knowledge of both practically useful and subservient to human happiness. True religion and true philosophy must ultimately arrive at the same principle.”
We are now struggling to get over this obstacle and we’re getting bogged down, losing sight of wonky teeth but hold on.
Understand that Newton wasn’t a scientist he was a philosopher, we accuse Newton of being a “lineal thinker” but have you ever tried to read his work, the work he wrote, not the interpretations and translations?
I tried, but it’s impossible, so is it any wonder that science has dumped the philosophy, it’s just too hard. It is convenient for science not to have to do the philosophy bit, it can just measure things and say ‘more research is needed”.
Millions of peer reviewed articles are dumped on to data bases, but what do we do with all this information?
We believe what we’ve been told and don’t question or reason on the truth. If you want to know more about Newton there is some good information at https://sourcebooks.fordham.edu/mod/newton-princ.asp).
So what does this have to do with wonky teeth?
Even if Still had no knowledge of Newtons rules of natural philosophy, if Still discovered the ‘science of osteopathy’, then his philosophy must be that of Nature because they are inseparable.
In order to understand wonky teeth, we must understand the rules of natural philosophy because it offers insight to what I will write. Do not confuse these rules with Newton’s laws of physics, that not what I’m talking about. As I suggested, the definitions of words in Still’s day are not the same as today, so how does the definition of science that Still referred to match the rules of natural philosophy? The answer is simple, in his day science was natural philosophy.
SCI’ENCE, noun [Latin scientia, from scio, to know.] (1828)
1. In a general sense, knowledge, or certain knowledge; the comprehension or understanding of truth or facts by the mind. The science of God must be perfect.
2. In philosophy, a collection of the general principles or leading truths relating to any subject. Pure science as the mathematics, is built on self-evident truths; but the term science is also applied to other subjects founded on generally acknowledged truths, as metaphysics; or on experiment and observation, as chemistry and natural philosophy; or even to an assemblage of the general principles of an art, as the science of agriculture; the science of navigation. Arts relate to practice, as painting and sculpture.
All we have to do now is understand how natural philosophy will help us understand wonky teeth and help us use Still’s work in our everyday practice because after all, what is the point of what he writes if we can’t use it? What are these rules and please research these rules for yourself they are old and been interpreted many times over, do not just believe what I write.
Rule 1: We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances. = The simplest explanation is most likely,
Rule 2: Therefore, to the same natural effects we must, as far as possible, assign the same causes.
Rule 3: The qualities of bodies, which admit neither intensification nor remission of degrees, and which are found to belong to all bodies within the reach of our experiments, are to be esteemed the universal qualities of all bodies whatsoever.
= universal law of physics and explanations of phenomena determined through scientific investigation should apply to all instances of that phenomenon (applies to all heavenly bodies, stars and planets)
Rule 4: In experimental philosophy we are to look upon propositions inferred by general induction from phenomena as accurately or very nearly true, notwithstanding any contrary hypothesis that may be imagined, till such time as other phenomena occur, by which they may either be made more accurate, or liable to exceptions.
= Any law of physics is open to future correction or improvement,
The point of all this is to lay the foundation of the most important aspect of still’s work:
Analogies
Still’s book is full of analogies, because per definition they ‘enlighten the mind’ (see definition below)
Analogies help us understand these natural laws of cause and effect. I make no apologies for the use of analogies in this article.
The laws that govern the one thing we do understand, are also present in the comparable thing we don’t understand. For example, the phenomenon ‘congestion’, is the same when applied to traffic congested roads, as it is when we talk about ‘liver congestion’. The “universal laws of physics apply to all instances of that phenomenon” even though the specific parameters maybe different, the phenomenon is the same, right through from congested cities down to congestion on the cellular level. The one form of congestion we can see happening and the other we can’t. Scientists usually discard analogies in their research, but do use them to ‘explain’ their findings.
Analogy
ANAL’OGY, noun [Gr. ratio, proportion.] (1828)
- an agreement or likeness between things in some circumstances or effects, when the things are otherwise entirely different. Learning enlightens the mind, because it is to the mind, what light is to the eye, enabling it to discover things before hidden.
These are some examples of the numerous analogies that Still uses to help us understand his experience and the physical laws that govern them.
• Building houses and the carpenters apprentice.
• Car mechanics, aligning the wheels with “straight journals”
• The consequence for our health when the sewers in our cities becomes ‘congested and blocked’
• The Klondike of life. That’s where the gold lies.
If we cannot understand that training to be an osteopath is no different than training to be a carpenter, or if we cannot understand the principles behind the use of ‘straight journals’ or how blocked sewers in our cities lead to sickness and disease in our society, we will never understand these works. In my opinion the “Klondike of life’ is the most intriguing analogy of all, it is where the “gold lies”. We find the answer to all our problems not in books, but in nature, that is to say in our environment, not just in woods and forests, but in our towns and cities, communication networks and sewers, he mentions them all.
When something goes wrong with them, we understand the logic behind the problem, but when we become sick, we do not understand that exactly the same principles apply to us. Look around you that’s where the gold lies.
7. Philosophy of wonky teeth
Having finally laid the groundwork for the reasoning behind “wonky teeth” I would like to remind you that this article (part I) will only go so far as to discuss my reasoning with regards to the cause’ of the ‘effect’. When we look at these photo’s we see one small piece of my patient, if our osteopathic training was any use, we should be able to contemplate answering these questions.
What is causing this situation?
What is the body trying to correct?
Why is the body now able correct itself?
It is your intuition, and experience that should tell what is causing this situation and not our osteopathic testing.
It is imposable to document this situation using the osteopathic jargon we have been taught, in such a way that we can fully describe this situation in all it’s dimensions. However, using analogy-based descriptions allows us to visualize and reason as to cause and effect.
Can you think of an analogy that would describe this situation, or do you need to do osteopathic testing first?
What do you see that triggers your mind to ask a question?
What would that question be, Still gives us clear instruction as to how we should deal with the situations we are confronted so why do we ignore these instructions?
Unfortunately, because we have had no formal training in these instructions, we don’t know what they are.
Because I had no knowledge of Still’s instructions, in 2011 I was left to deal with the situation by trusting my own intuition. And I clearly remember the process I went through;
– I saw something that intrigued my mind.
– That triggered me to ask a question.
– The answer to that question lead me to reason, that it must have something to do with this.
– I formed an idea in my mind what was happing to the tissues.
– I checked my reasoning and readjusted what, in my mind was causing the situation.
– I was surprised by the results,
This is a very complicated paragraph because its written in the old-style English and I had to read it many times and redefine all the words in my mind to understand it. As far as I can see, he was so adamant about what we should do, in this one paragraph he mentioned it once and the repeated it another three times, what is it that we should do?
If you look at it closer by studying this paragraph sentence by sentence. He tells us four times we must;
“Reason”
Reason
REASON, noun re’zn. [Latin ratio, which is from ratus, and which proves reor to be contracted from redo, redor, and all unite with rod, Latin radius, etc. Gr. to say or speak, whence rhetoric. See Read.]
1. That which is thought or which is alleged in words, as the ground or cause of opinion, conclusion or determination. I have reasons which I may choose not to disclose. You ask me my reasons. I freely give my reasons. The judge assigns good reasons for his opinion, reasons which justify his decision. Hence in general,
How we can apply Still’s instructions?
Step 1. We can see something is going on here.
This means your senses will tell you something, they will intrigue your mind because your five senses would have noted a “variation from normal”. The material body has “action”, we can see this ‘variation’. In 2011something triggered me to ask a question, what was it?
– I saw a scar on the right lower lip, a scar and reason that a scar means damage and damage means excessive force so the question is, ‘how did the scar get there?
– Answer: A fall against a table a five or six years ago, only a bust lip nothing was broken.
Step 2. Reason on solidity and size.
That what you see must trigger a question, the information you get according to the answer will determine the ideas you might have on the solidity and size of the tissues.
Bit testimony of the witness, is nothing less than everything you have experienced not just as an osteopath but as a person and in your own life. This combined with all your knowledge will give you all the information to do this, Because we cannot know what is going on (in motion) we can only ‘reason’ and use our ability to compare this with a similar situations to ‘enlighten the mind, because it is to the mind, what light is to the eye, enabling it to discover things before hidden.
Find an analogy, compare it to something you know, because similar causes will have similar effects. Here we have a possible ‘variation from the normal condition’ we know that there must have been excessive force because there is damage, it is visible and has been visible for a long time.
The boy was nine years old at the first consultation, if this happened a few years before, how is that significant?
– At the time I reason that excessive force would compress the tissues making them hard and solid, I have marked the point of impact on the lower right lip and orientation line of upper and lower rows.
I reasoned that a scar resulting from a fall would probably have consequences for the tissues in which the teeth are housed. All the tissues would become hard and compact, making it difficult for adult teeth to push through this hard material years after the incident.
I tried to imagine the forces in question and in my mind by looking for an example of what I do know, I looked for an analogy, when I found it, I was amazed how it is possible to see that the same forces in one thing have the same effects when applied in totally different circumstances. Below you will see my analogy of excessive force applied to the lower right quadrant of an object. I have added anatomical names to the picture to help you orientate my intention.
The photo is not demonstrating that my patient had a car accident’ it is in fact demonstrating the damage that can occur during an impact to materials that are not equipped to deal with. It is clear to see that the initial impact was on the lower right bumper and must have been a low object because the bonnet is not dented, only twisted.
When we compare the photos, we can see many similarities and it is even possible to extrapolate the marker lines I have used on the photo of my patient onto the photo of the car. The point of impact on both the car and my patient is clear to see. We can even compare structures of the car with these of the neuro and visceral cranium.
Take a good look at the car and imagine the force needed to do the damage and how these forces disbursed from the point of impact.
The small scar under the lower lip was something that caught my attention.
After my first impression I tried to build up a picture of the whole “story”, not “history” of my patient, based on what I saw and not a standard list. This intrigued me to ask his mother how he ended up with the scar. Apparently, he had a fall against a table when he was learning to walk, busting his lip. No medical attention was needed and the lip healed on its own leaving a small scar. When we take a patient’s history, we only take into account the more serious accidents that need medical attention and would never associate them with ‘wonky teeth’.
A trained mechanic could look at the photo of the car and immediately he would be able to estimate the damage not only visible but hidden.
He would know roughly which parts would only need straitening out, which would need replacing and which systems of the car would not be functioning.
There would be damage to electrical systems, fluid pipes and tubes that supply all sorts of systems.
He would know just by looking, if there is any point in repairing the car.
We as osteopaths are not trained auto mechanics and therefore can only rely on our basic knowledge to guess what might be damaged on this car however, we have no auto-mechanical skills and therefore have no way of repairing the damage.
To demonstrate this point I asked a team of mechanics to look at this photo and asked them to make a list of things they thought might have happen to this car. It is in Dutch, but they say in general, it must have been a substantial force, the car must have hit something low e.g traffic bollard. They envisage damage to the chassis, shock absorbers, water reservoirs radiators air-conditioning systems. They also suspect that the whole cage construction could be distorted but they would need to look at the roof of the car, any signs of deformation on the roof would mean that the car would probably be written-off.
When we only look at the teeth, we are missing the basic point of the situation. The teeth have been forced into certain positions by the surrounding tissue in which they are housed. The teeth are just the passages on the bus, they go where the bus is taking them.
When we hide the teeth that are attracting all our attention, we are forced to use our senses differently. In this photo our visual perception is now impaired because we are missing parts of the picture but we still can see certain aspects: offset midline, slanting horizontal line and small scaring. The scar on the lower right lip, suddenly becomes even more prominent now that the disarrayed teeth are no longer attracting all our attention. We can see the scar running from under the lip and follow it right over the lip itself. We may therefore reason that that a certain amount of force has impacted the tissues and that force may have consequences for the surrounding tissues locally but also in general.
Step 3. Use ALL your senses to gather more information
Once we have reasoned as to possible causes of things that have initially come to our attention and we have considered what the consequents might be for ALL the tissues locally but also in general, we then have an idea of any possible changes in ‘solidity’ and ‘size’.
We can then use all our other senses to evaluate the situation. When we have gathered all the useful information, we need our ‘mind’ instructs us what to do. We use our intellect to adjudicate and question these ideas.
This is no different to the process a car mechanic would go through when confronted with this car. They would look at it, their experience and knowledge would give them an idea of the damage and the consequents, they may even already make up their mind if it’s worth repairing. If it is worth repairing, they would then go on to look at what work needs doing by inspecting the car and damage. In the case of wonky teeth, this is the process I went through. Unfortunately, I only realized this after reading Still’s work again. I saw something, that gave me an idea, I checked the idea and corrected what I found and let nature do the rest.
Is that now so complicated, why do we make things so difficult for ourselves?
Not one osteopathic test I have ever been taught helped me in this case. I suspect that most of us do what Still is advising every day, but try to explain what we do in regards to what we’ve been taught and if we are really honest with our selves, it’s not true.
8. Why do we ignore the advice we’ve been given?
“Good advice is always certain to be ignored, but that’s no reason not to give it.” – Agatha Christie
It seems as though we have filed Still’s work in the ‘obsolete’ file and now we say that we have progressed and we say that we now know more that he did, but have we progressed and more importantly, have we ‘improved’ ?(see definition progressive, below) In order to progress we must also ‘improve’ but Is modern osteopathy an improvement on the osteopathy he discovered and practiced?
Or is it just something else with the same name?
Progressive 1828
PROGRESS’IVE, adjective Moving forward; proceeding onward; advancing; as progressive motion or course; opposed to retrograde.
1. Improving. The arts are in a progressive state.
Our knowledge has greatly improved, Still didn’t have a fraction of the knowledge we now have.
But have our capabilities and achievements improved as much as our knowledge?
Can we achieve anywhere near the results of his era when dealing with sickness and disease? For example, Still didn’t even know what blood was, but somehow knew it was important.
Did he have to know all that we know to achieve what he achieved?
How can we expect to achieve anything resembling the osteopathy that he discovered if we don’t even know what he discovered or take notice of the advice he is giving us?
Our whole profession has based itself on the medical profession, our experiments, methods and even our peer reviewed articles are mimicking these systems, we try so hard to fit in and be accepted that we even managed to ignored his very first words,
We fill our libraries with books and peer reviewed articles, gathering more and more knowledge. But what do we do with it? The one thing we do not do is study in detail the work of the one person we say we try to emulate every day.
We too have fallen into the copy-paste quote, un-quote system.
Where is the natural philosophy?
Where is the reasoning, after all we have already established that it is true science?
You may have thought that copy-paste was something from our times, but it’s not…more than a hundred years ago they were ‘clippers’ and ‘authors by quotation’
Instead we keep writing peer reviewed articles and we keep quoting and citing other ‘research’ but we have stopped reasoning. More than a hundred years have passed and nothing has changed, even in his day science stopped reasoning.
That is not to say we should exclude these systems but we just should not consult them for ‘instruction’. However, the ‘information’ gathered from scientific experiment however is an essential part of philosophy. Ultimately we give in and follow suit.
In answer to the question ‘why do we ignore the advice we’ve been given, Still provides the answer himself, he writes;
We fear being called quacks, we fear losing our income and so we adopt the rules of medical science, we try to ‘prove’ ourselves. We are being told from the very beginning that we should not look to medical authors for ‘instruction’ and even went so far as to warn us that we would be “very foolish” to do so.
When we do our osteopathic testing and try to name and “measure” dysfunctions, we too are trying to be scientists. Flexion, extension, rotation, side-bending, abduction adduction……. are all “scientific” measurements of direction and are not mentioned anywhere in Still’s book, a book that is laying out the basic mechanical principles.
Things like direction, time and boarders are inventions of the human imagination, in Nature they do not exist. This begs a question:
Who was it then, that made fools of us?
One of the most important pieces of advice that we have chosen to ignore is;
It has always been a problem for me that I have been expected to regurgitate Greek and Latin in order to prove my osteopathic capacity. We have invented osteopathic jargon in an attempt to impress our medical counterparts and not to makes us better osteopaths.
We are pleading with them to respect us, because we too can talk Greek and Latin.
The problem is, Greek and Latin are the languages of exclusion, used to express an intellectual prowess over the lesser learned. Patients cannot understand these words and are therefore excluded from the medical club.
We hide the need to use Latin based words under the pretense that we need to communicate with our colleagues, however if our osteopathic terminology cannot in anyway describe the situation of wonky teeth, then it is clearly not helping us communicate. A picture of a crashed car ‘enlightens the mind’ (see def. analogy) more than any osteopathic jargon that I have ever heard.
In our attempt to impress our medical counterparts, we have inadvertently excluded our patients, and ultimately ourselves from the “experience.”
For example, we do not experience myalgia of the musculus rectus femoris after running a marathon, we experience aching thigh muscles. We do not experience contusions of the olecranon; we experience a twisted elbow. I do however, have experience with a fractured clavicular. As a young boy, I was the only one in my class that knew what a clavicular was. The important people in the white coats were telling me that the pain I was experiencing was caused not by “my” collar bone, but by “a” fractured clavicular.
In the case of wonky teeth, osteopathic Jargon in Greek and Latin fails miserably to describe the situation in all its dimensions. It only amounts to a shopping list of dysfunctions, excluding us from the “experience” of what’s happening. Because I was trying to impress everyone with my use of scientific terminology, the original title of this article was;
‘The effect of osteopathic interventions in the case of a nine-year-old male presenting a mal-occlusion’
This was never a case of a 9-year-old male presenting a significant mal-occlusion to me, he was at the time;
A 9-year-old boy with wonky teeth.
By viewing my patient as a 9-year-old boy with wonky teeth, we are then free to empathize and experience. We can relate to a 9-year-old boy, who is growing, learning, falling, crashing and bumping his way through life, but a 9-year-old male is distant and sterile from interpretation. When we say “wonky teeth” we immediately open our minds to the fact that if something’s wonky there must be a reason why. When we say “mal-occlusion” it becomes a measured fact, it is a scientific conclusion, and therefore, the end.
9. Is this osteopathy?
At this point I would like to ask you to reason for yourself if the case of ‘wonky teeth’ is osteopathy, or not. Your answer ultimately depends on your choice of definition of osteopathy.
A.T. Still himself isn’t around to ask the question ‘is this what you meant?’.
We only have the words that he wrote and the dictionary he used. I am aware that there are different versions of his own definition, but as I say, I have reason to believe that this version based on his first writings from when he first put pen to paper in circa 1892. My second article, ‘Part II’ will discuss the “mechanical principles’ how apply his mechanical principles in the case of wonky teeth and in other cases.
10. Wonky teeth 2018
After 2011 it took a few years to rediscover Still’s work. At first, I only had my intuition but no foundation. After getting acquainted with his work again I began to find a foundation for my intuition.
In December 2018 I saw a 19-year-old female patient of mine that I hadn’t seen for a few years. I noticed that she was still waring braces so I asked how long. She said “four years” …. Yes, I do mean 4 years. In the photo below you will see the tooth growing in the palatine bone, just won’t budge.
The changes you see took place in a nine-day period between 11th of December 2018 and 20th of December 2018. Six weeks after the first consultation 6 weeks the dentists commented that the tooth has not only become more prominent it has also moved almost 2 mm back into line. Pre intervention December 2018
Post intervention December 2018
This suggests that ‘A nine-year-old boy with wonky teeth’ is no accident or chance event, the biggest difference is that in 2011 it was pure intuition and in 2018 it is intuition with foundation. The reasoning behind these and other documented changes I will discuss in Part II, ‘The Mechanical Principles’. What has changed? It is clear to see that the palatine bone has widened and the tooth is more prominent. These changes took place in nine days, the braces have been pulling on the tooth for four years and it wouldn’t budge, why? what is causing this effect? What has changed? we can never know, only reason.
I would like to point out that osteopathy isn’t orthodontics, we must realize that the changes we see here only mirror the changes that happen everywhere in the ‘whole’ person and in all the tissues. The advantage of the fascial region is, we scan see the ‘action’ we can see the ‘derangements.’ So if osteopathy is about ‘readjusting’ derangements’ back ‘normal’ and we our true to our word, then something must change. It doesn’t matter what the situation is, something must change, in the fascial region it is easy to see these changes.
11. Conclusion
This is the only definition of the word ‘conclusion’ that I could find that makes any sense, it’s written on the side of a cup. “The place where you got tired of thinking”.
I don’t know who wrote it or even where I found it. There are no conclusions in Nature, it goes on and on and up until now, it has never stopped.
So, when you make a conclusion, you stop thinking, you stop thinking about that subject, it ends.
Unfortunately, because you can never know for certain what the causes of things are, you can only do what we’ve been asked to do;