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In 1874 Andrew Taylor Still brought osteopathy into the world. At that time the work of Pasteur and Lister was unknown, and many patients who survived the crude surgery that was practised would invariably succumb to sepsis and gangrene. Medicine relied on poisons and heavy metals in heroic doses to try to kill disease. For instance, in the British Medical Journal of January 1895, it was advised to treat diabetes using mineral acids and opium; skin cancer could be treated using arsenic paste, and enuresis should be treated with vigorous use of strychnine. Still recognised the uselessness of the drugs and poisons that were endemic, and he loudly proclaimed the natural regenerative powers of the body. Nor was he alone in his beliefs; in 1894 William Osler first published his Principles of Practice of Medicine, in which he lambasted the use of drugs, and extolled the use of diet , good nursing and hydrotherapy. He stated:

"Medical antipyretics are not of much service in comparison with cold water . . . Typhoid fever is not a disease to be treated by medicines . . . Many specifics have been vaunted in scarlet fever but they are all useless."

It had taken the death of three of his children from meningitis in 1864 for Still to realise that the drugs and preparations he prescribed were useless. For ten years he studied the anatomy of the body; he dissected many bodies, and he carried bones in his pockets so that he could constantly consider their structure and function. When he formulated his conception of health and disease he stated:

"I took the position in 1874 that the living blood swarmed with health corpuscles which were carried to all parts of the body. Interfere with that current of blood and you steam down the river of life and land in the ocean of death."[1]

Still claimed that osteopathy was a complete system of healing, and there was no need to rely on any form of treatment other than the correction of the structural faults of the body. The two exceptions to this were midwifery and surgery. He treated everything from typhoid fever to croup to dislocated hips by massage and manipulating the spine and peripheral joints. He stopped using drugs, and stimulated natural immunity. And his patients got better.

With the advances that were made in the treatment of infection, and the advent of antibiotics, osteopathy lost the willingness to treat disease, and the scope of treatment became more limited. In 1956 the General Council and Register of Osteopaths stated that:

"Osteopathy is a system of therapeutics which lays chief emphasis upon the diagnosis and treatment of structural and mechanical derangements of the body."

In doing this, osteopathy became more acceptable to the medical profession, which viewed it as a musculo-skeletal specialism that was limited to treatment of spinal and peripheral joint strains, sprains and dislocations.

However, in 1948, Irvin Korr, a physiologist who started out with the intention of disproving some of the 'wilder' claims of osteopathy had stated:

"The osteopathic profession has earned its place in history and society, through having developed, and effectively and skilfully applied a system of diagnosis and therapeutics based on the role of the somatic structures in disease. It has demonstrated that the somatic component can be most directly and effectively influenced and controlled by adjustment of the vertebral and para-vertebral structures."[2]

Korr's research work has continued to this day, and the effects of mechanical stress on the body framework, with the subsequent responses in the muscular, vascular and nerve systems were well documented and understood. However, Osteopathy remained entrenched in the musculo-skeletal system and became a highly effective physical therapy.

During the same period Naturopathy was also becoming more widespread. Naturopathy had grown out of Nature Cure, the practice of natural therapeutics, which traced its origins as far back as the 1700s, when the curative effects of hydrotherapy were first utilised. Naturopathy is based on four main principles:

The individuality of the patient.

2 That one should attempt to establish and treat the cause of the condition, not just to treat the symptoms.

3 That everyone has the potential within their body to heal themselves.

4 The need to treat the whole person, and not just the local area which may be affected.

Naturopathy recognised Still's assertion that physical treatment of the musculo-skeletal system and manipulation of the spine to influence the nerve supply to organs and blood vessels had beneficial effects on the health of the body, and could therefore influence disease pathways. They went further by using dietetics, hydrotherapy, psychology and education in aiding the patient to get better. In 1954 The British College of Naturopathy and Osteopathy was opened in Hampstead which combined both therapeutic systems. It continued to emphasise the principles of natural therapeutics, and holistic treatment. Its students study for a diploma in Naturopathy, as well as a degree in Osteopathic Medicine which is validated by the University of Westminster, and are eligible for membership to both the Register of Osteopaths, and the Register of Naturopaths.

The scope of osteopathic treatment has therefore broadened away from just the physical strains, and it is used in all walks of life. A musician whose playing puts undue stress through his spine and supportive musculature also finds that the function of his bowel and kidneys improve when the spinal strains are treated. The patient with bowel problems is treated with diet, hydrotherapy and relaxation as well as having the spinal levels that supply the nerves to the bowel adjusted if necessary. By seeing the symptoms of dis-ease as the body's energy being turned to the work of eliminating the disease factors the practitioner interprets the body's intention and collaborates with it to assist the body to heal itself.

Healthy tissues cannot be built from deficient foods, and naturopaths emphasise the need for the change from an unbalanced diet to one that reflects the needs of the patient, whether they are a growing child, an active sportsman or a sedentary business man. A return to a natural health diet usually brings about immediate benefits. Where it is necessary, a short fast can be extremely beneficial. It allows a digestive or physiological rest period, during which time the body has a chance to eliminate waste products that build up in the tissues. The use of hydrotherapy in the form of hot or cold packs, compresses, baths and sprays is often used, particularly in inflammatory and congested tissues, to improve drainage and restore the function of the body more quickly.

It is important that patients are taught to look after themselves, and apart from the physical framework many practitioners use relaxation and meditation techniques that are adapted to each patient to help them gain a better understanding of themselves and their problem.

As an adjunct to treatment, some practitioners may recommend herbalism or homoeopathy to replace painkillers or anti-inflammatory drugs that are suppressing the body's natural reaction to dis-ease. By stimulating the body's inbuilt healing mechanism and aiding it to restore complete health, the body is strengthened, and is better able to resist the stresses of modern life.

The overuse of antibiotics by the medical profession has lead to the creation of bacteria that are resistant to them. The spectre of 'superbugs' has shown where the suppression of natural immunity has had adverse effects on humanity. Doubtless the drugs industry will be working hard to develop different antibiotics to kill the superbugs, rather than working to improve the patient's health to increase natural resistance. The naturopathic approach to holistic medicine will become a cornerstone for the improvement of the health and well-being of their patients.

Case History

Mrs S was a 39 year old housewife and mother of two children aged 16 and 13. She had sought a consultation because of migraines, which she had suffered since her early teens, and they had worsened considerably in the last three years. She had an attack twice a week, on average, and had extreme nausea, with some vomiting on occasions. If she took migraleve tablets in the early stage she could reduce the severity of the attack, but the quality of her life was severely affected nonetheless. She had had X-rays of the head and neck, and an MRI scan of the brain, which had showed no abnormalities. Numerous blood tests had all been normal. She had tried various prescription drugs, with little success. Her energy levels were poor, and she became tired easily.

She had developed asthma about two years ago, and was using ventolin and becotide inhalers on a regular basis. She admitted to being fairly stressed, and tried to swim regularly as a means of exercise, since she had been told this would be good for her asthma. She was regularly constipated, but did not take any form of laxative.

An examination of her diet revealed that she drank between six to seven cups of tea or coffee a day, and there was a heavy usage of dairy products, mainly in the form of milk and cheese. There was also a fairly high intake of refined carbohydrates and sugar, but Mrs S did not eat red meat at all.

On examination it was revealed that she had a slight scoliosis (curvature of the spine) causing the right side of her ribcage to be to be slightly restricted in its movements compared to the left. She had a typical asthmatic posture: square shouldered, tight muscles in the neck and upper back, and upper ribcage elevated. There were restrictions in movement in the upper part of the back (thoracic spine), the upper lumbar spine, the base of the neck and the base of the skull where it joined the neck. Her curvature reduced somewhat when she sat, but did not disappear altogether. She had a slight leg length difference of about 1 cm, the left being shorter. Her blood pressure was 143/92.

She was treated with soft tissue massage to the whole of the spine and shoulders to reduce the muscular tightness. The neck and upper back were gently mobilised and the ribs were stretched passively. On subsequent treatments the spinal restrictions were manipulated. She was also given some abdominal massage, and advised to apply warm packs over the lower part of the abdomen. She was given abdominal breathing exercises to improve the diaphragm and advised to try to set aside time for relaxation every day. She was advised to try herbal teas, or natural coffee substitutes, to reduce her caffeine intake, and to considerably reduce her usage of dairy products and refined carbohydrates. Advice was given regarding a healthy dietary balance to include fresh fruits and vegetables, and foods containing vitamin B12, which she was lacking as she did not eat red meat.

Initially the results were good: her migraines reduced in severity and frequency after three treatments. However, after a two week holiday in Wales the frequency increased slightly. She had also had to make greater use of her inhalers. Mrs S was particularly upset by this since she had been very active and had swum every day. She did admit that she had not eaten as healthily as she should have, due to eating out whilst away, but had not slipped up that much.

She also had developed a pain in the lower part of the lumbar spine on the left, and into the left buttock. This was revealed as a strain of the sacro-iliac joint, and corrected. On further questioning she revealed that she only swum breastroke with her head held high, as she did not like to put her face in the water. It emerged that she had a 'screw-kick' on the left, which had apparently been throwing the left side of the pelvis forward on each kick, thus straining the sacro-iliac joint. She was advised to obtain lessons to correct this, and to try to learn to lower her head whilst swimming, to remove some of the strain on her neck and shoulders. Further treatment to the spine again helped reduce the frequency of the migraines.

During the course of treatment an article was published on the harmful effects of chlorine in swimming pools, which the osteopath read. When he questioned Mrs S she revealed that her local pool did have chlorine treated water, and that the pool in Wales had been a lot stronger. It was decided to increase her anti-oxidant containing foods, and she was given liver pumping, and prescribed a short juice fast to help cleanse the liver. As an experiment Mrs S stopped swimming altogether for a period. The response to the overall treatment was excellent. Not only did her migraines reduce immediately, but her asthma also improved dramatically. Over a period of four months she was able to reduce her usage of inhalers to an 'only when necessary' level and she admitted to only carrying it as a precaution. As the diaphragm began to be used properly the bowel function improved, and the constipation improved tremendously.

Mrs S began to spend regular time on relaxation techniques and her blood pressure was measured at 125/82 when she was discharged. The mobility of the spine improved, and she was prescribed a heel lift for the left side to correct the leg length discrepancy, her migraines virtually disappeared. She now travels 12 miles to a swimming pool that does not use chlorine in the water, as she likes to keep her fitness. The quality of her everyday life improved to such an extent that she now takes a much more active part in her children's activities, and as she put it: "the whole family has benefited".

Useful Addresses:

The British College of Naturopathy, Frazer House, 6 Netherhall Gardens, London, NW3 5RR Tel. No.: (0171) 435 6464
The General Council and Register of Naturopaths, Goswell House, 2 Goswell Road, Street, Somerset, BAI6 OJG Tel: (01458) 840072 Fax: (01458) 840075
The General Council and Register of Osteopaths, 56 London Street, Reading, Berkshire, RG1 4SQ Tel: (01734) 576585 Fax: (01734) 566246

References

1. Still AT. Autobiography p.343. Kirksville, Nissouri, 1908.
2. Korr IM. The Emerging Concept of the Osteopathic Lesion, ibid., 1948, November issue.