Robert E. Evans, D.O.

OPP/MS-I

HISTORY AND PRINCIPLES OF OSTEOPATHIC MEDICINE

Goals:
The student will: 1. 2. 3. 4. understand the relationship of medicine of the past and Osteopathic Medicine. become (more) aware of the history of Osteopathic Medicine. evaluate ideas relative to the future of Osteopathic Medicine. become more cognizant of the principles of Osteopathic Medicine.

Objectives:
The student will: 1. 2. relate certain historical facts to Osteopathic Medicine. identify important dates and events in the life of Andrew Taylor Still, the first osteopathic school and early osteopathic medicine. realize the impact on our public image of increasing numbers of graduates. realize why the light into the future of Osteopathic Medicine has never been brighter describe and begin to apply the philosophy and principles of osteopathic medicine.

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Introduction to Osteopathic Medicine Educational Goals 1. Become proficient, efficient, competent, and caring osteopathic physician. 2. Learn to apply Osteopathic principles ALWAYS in evaluating and treating patients (7 core competencies). 3. Develop optimal clinical diagnostic and management/treatment skills through the synthesis of osteopathic concepts. Objectives 1. Define Osteopathic Medicine. 2. Discuss how osteopathic medicine differs from allopathic medicine. 3. Discuss the differences between OPP (osteopathic principles and practice) and OMT (osteopathic manipulative treatment). 4. Define osteopathic principles and list. 5. Contemplate your own reasons for becoming an osteopathic physician. 6. Evaluate what you would like to receive out of your education here at LECOM. What is osteopathic medicine System of healthcare based upon a particular philosophy that focuses on a holistic approach to a patient, understanding of culture and beliefs, a preventative approach, and the special art of osteopathic manipulations; to support the musculoskeletal system. *Differs from MD medicine because MD medicine treats the specific body part, not the interconnected source of the pain. **DO medicine will give us more then MDs because we will be able to determine the true source of an ailment. Principles of Osteopathic Medicine 1. Treat the body, mind, community, and spirit as one. -OMT, Cultural, prevention, mind-body, environment, energy, research, nutrition, surgery, pharm, other= Facets of DO medicine. 2. Structure-function= Anatomy-Physiology OMM/OMT 2

Definition: Therapeutic use of the hands to restore normal structure (anatomy), and hence function (physiology). Osteopathic Philosophy, Principles, and Practice 1. Holistic emphasis (unity of body, mind, spirit) 2. Care directed towards funding and restoring health (homeostasis) 3. Comprehensive healthcare: -Interventional (medical, surgical, psychiatric, OMM). -Preventative medicine (exercise, nutrition, etc)

HISTORY AND PRINCIPLES OF OSTEOPATHIC MEDICINE

I. Brief History of Medicine A. Medicine is the natural art conceived in sympathy and born in necessity. B. Greek medicine formulated the idea of preventative medicine, stress diet and how the patient lived, and how it influenced that persons life. -The body has the innate ability to heal itself. C. Alternative healthcare developed in the 1800s in the United States. D. Hananen developed Homeopathy It is a system of medicine, based on the system of minute remedies, that in massive doses produce symptoms in healthy individual, similar of the diseases being treated. -Reform movement because of massive dosages of medicine. E. Chiropractic medicine system of treating ailments through adjustments and manipulations for health. Based on the system that diseases are traceable through misalignments in the spine. F. Osteopathic medicine Whole body, holistic care, complete physicians. 3

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History of Osteopathic Medicine A. Osteopathic Medicine one of two distinct schools of medicine in the United States -We can do anything and MD can do, and more. -Integration of science, philosophy, and art. The importance of the musculoskeletal system. -Full expression of life. -Allows us to walk, talk, and is 60 percent of our body Andrew Taylor Still - born August 1828. -Founder of Osteopathic Medicine, the medicine of the future. The relationship between Dr. Stills childhood headaches and his later development of osteopathic manipulation. -Removed rope from swing and rested it on his head and fell asleep; when he woke up, his headache was gone. -Helped to contribute to his idea of osteopathic medicine. The times in which Still practiced medicine were significant in guiding his career. -Studied under his father who was a doctor, minister, and farmer. -He was a hunter, studied the anatomy of his animals he killed. -Issued an MD degree. -Anatomy let him know the structure and function in the dead -Against slavery -Rose to the rank of major Still broke away from allopathic medicine on June 22,1874, when he "flung the banner of osteopathy to the breeze." -Laxatives, blood leading, mercury poisoning as treatment for sick. -Iatrogenic disorders symptoms caused by the physician with a drug. -AMA antagonism We are not against MDs, just disagree. -Three children died, made him want to treat whole person, not just the disease. -Still became obsessed with the lack to save patients, wanted to figure out a new way to treat illnesses to eliminate guessing. -Believed in natural immunity, body has its own pharmacy to treat itself. 4

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-Concluded that a patch up approach would not due, need to treat whole patient. -Key is to find and correct anatomical deviations -Must maintain adequate circulation. G. Still opened the American School of Osteopathy in Kirksville, MO., in 1892. -Flung the banner osteopathy to the breeze -Huge crowds would gather for his new treatment. -Baker University in Kanses, not successful, osteopathy was seen as quackery. -Taught his two sons osteopathy. -First class of Kirksville campus had 5 women. -combined Ost=bone and pathy= pathology

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The Flexner Report of 1910. -Brought about better quality in the remaining medical schools that were teaching. -Devastating judgment was passed on his 5 schools. 120 schools were removed, ended alternative schools. 66 MD schools left, 6 DO schools left. Still died in 1917 at age 89. -After being weakened by a stroke.

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The Great Swine Flu Pandemic of 1918-1919. - Killed over 500,000 in US and over 20,000,000 in world. -Patients with non-osteopathic care- 30 percent -Osteopathic- % The effect of World War I and World War II on the Osteopathic Medical Profession. -AMA announced that if DOs were allowed to practice in WWI and WWII, then MDs would not go. -After WWII, DOs thrived. -MDs started letting DOs in their hospitals around 1960. Loss of California 1961-1962. -MDs changed their philosophy of going against DOs -65 dollars to get MD degree to get rid of DOs -Many DOs rejected this offer, and the DOs survived. 5

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-Remorse of the X-DOs, fewer then 8 percent were happy with their MD degree. -Took over 50 years for DOs to be able to be in military medicine. M. Michigan established the first state-supported osteopathic medical school in 1969-1970. -32 Osteopathic teaching institutions - 26+3 branch+3 satellite osteopathic schools. -20% of all medical students -DOs are fully accredited in all 50 states.

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Principles of Osteopathic Medicine: 1. The body is a unitthe body is an integral unit. Every part is negatively and positively influence by other body parts. Treat mind, body, and spirit. Treat the person who has a problem=Total patient. Structure and function are reciprocally related Any body part carries out a function based on a signal. Every structure is designed to do a certain function. Maintain weight, exercise, no smoking, little alcohol, blood pressure, cholesterol in healthy limits to maintain health. Also need to maintain proper vertical alignment. The body possesses self-regulatory mechanisms Carotid sensors monitors blood pressure. These things happen without our control. Must maintain proper health and alignment for these mechanisms to work. The body has the inherent capacity to defend itself and to repair itself We are exposed to millions of bacteria a day, and are able to defend ourselves. We get a cold or flu it goes away, we get cut and it heals.

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When normal adaptability is disrupted, or when environmental changes overcome the body's capacity for self-maintenance, disease may ensue Microorganisms, flu epidemic, stress of medical school, volcano eruptions all influence health and immune system. Rational treatment is based on the previous principles palpatory 6

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Movement of body fluids is essential to the maintenance of health When you made adjustments, it would relieve pain but also symptoms of other diseases. The role of the artery is supreme, any organ would be kept in health if there was no blood restriction of blood to that organ.

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The nerves play a crucial part in controlling the fluids of the body-> encourage healthy lifestyle, and alignment.

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There are somatic components to disease that are not only manifestations of disease but also are factors that contribute to maintenance of the diseased statesomatic dysfuction=typical strains on body, vicerosomatic= coming from an organ. Somatoviceral reflex= muscle problem making stomach hurt.

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Future of Osteopathic Medicine

-5,000 DOs a year are made -Role of physician has changed, its a partner in health maintenance and disease prevention=been the DO way for 100 years. -Each person is the owner of their personal health care system. -Has a role in total health care. -The goal in manipulation is to control and maintain a state of homeostasis. -Important for DOs to work with MDs, but to maintain our own identity. -DO may not become dominate degree, but can become the dominant philosophy. JZboyovski@lecom.edu or 8122/8104 for Ferreti