The Metaphysical Medicine
by Walter Llewllyn McKone
'They [osteopathy, surgery and dentistry] are directly related to those mental operations which are developed in the philosophy of Phenomenology, itself a post-Cartesian outlook. Relating this method to current philosophy of science, it cannot be judged in any way less powerful than Cartesian science, for while the latter has no verification procedure, relying upon falsification alone, Goethean science entails both falsification and verification, and thus might even be said to be more complete than Cartesian. Again, the only real problem with the approach the author sees is the fact that very few know of its existence.'
Towards a Man-Centered Medical Science. Forward by Rene Dubos, The Rockefeller University, New York, New York. 1977.
Osteopathy is a historicity and has to be understood in the context of nineteenth century science and philosophy. Since the beginning of the twentieth century osteopathy has been fragmented and the focus has been on the end i.e. manipulative technique, cranial, structural etc. rather than the beginning, the mode of consciousness of the osteopath. It is the osteopath that is the instrument not the patient or the learned technique, drug or manipulation. As a consequence it has moved from a practical philosophy of health to a physical therapy. Osteopathy has become a philosophical orphan and a schizophrenic profession.
To understand osteopathy is to understand the coming-into-being of an idea. Once this is written or practised it is the end of the idea. Dr. Still did not want his students to watch him work, "I did not want you to mimic me" (Booth, 1905).
This short paper is an introduction to the reclamation, development and application of osteopathy from its nineteenth century roots into the modern setting, within the space available.
The Modern Scientific Movement
Modern scientific thought started with the Jesuit educated Rene Descartes (1596-1650). He had trouble coping with the death of Galileo Galilei (1564-1642) and wanted to continue his work, ordering the world by using the tool of God, mathematics particularly geometry, hence Cartesian geometry (Toulmin, 1990). He altered mathematics to "decode" the book of nature. Numbers imposed an order but the true immediate order came with the use of the "=" sign. The top line is God and the bottom line is all outside the soul (Jonas, 1966). The result of the mathematics would lead to a New Order delivering us from the chaos of Nature.
Modern science derives from a religious methodology and is still performing the work on earth (universe) that God began. Today scientists have forgotten they are performing God's work and have forgotten what science actually means. Instead they strive for "facts" or certain knowledge about the world, which is very well when building a car but is weak when involved with natural phenomena. This style is known as the hypothetico-deductive method, championed by Sir Isaac Newton (1642-1727), which squeezes natural phenomena into pre-set criteria and is then called "research." This kind of research or "fresh look" is a Spanish Inquisition style of inquiry. We take it for granted that the objective/ subjective experimental approach is the only way, this is habit not proof.
The hypothetico-deductive approach has taken theory (originally from theoria to see) and placed it before the encounter with the phenomenon. So our "seeing" or "palpating" is already formed becoming a second hand experience. Osteopaths practice this approach in the teaching of osteopathic manipulative technique. For this reason A. T. Still did not teach technique, as "the tail would wag the dog." It is therefore theory-laden, before the experience of the phenomena, resulting in seeing and palpating what has been conditioned to think-sense, not what is there (Hanson, 1958). As Henri Bortoft (1999) says, "it's a bit like trying to find milk by starting with cheese."
'The paradigm of modern scientific method is Kant's "appointed judge who compels the witness to answer questions which he has formulated." Science believes itself to be objective, but is in essence subjective because the witness is compelled to answer questions which the scientist himself has formulated. Scientists never notice the circularity in this because they believe they hear the voice of "Nature" speaking, not realising that it is the transposed echo of their own voice' (Bortoft, 1996).
Nineteenth century North American philosophy and science
The development of science as a practical and historical influence in North America is attributed to Immanuel Kant (1724-1804) and Johann Wolfgang von Goethe (1749-1832) (Richards, 2002; Walls, 1995 and Walls, 2003). 'The problem of the knower in the perspective of the modern understanding was formulated over and over again from the beginning of the modern university dispensation by the man, not a member of the German university, who, along with Kant, most influenced it Goethe' (Bloom, 1987). Goethe was known as the first modern man (Cromphout, 1990) and his influence gave rise to the Transcendentalist movement as a way of seeing Nature. The Transcendentalists took their name from transcendental, to reason beyond the senses, from Kant's Critique of Pure Reason. The most famous of the Transcendentalists were Ralph Waldo Emerson (1803-1882), Henry David Thoreau (1817-1862), and Sarah Margaret Fuller (1810-1850). Emerson's Nature should be the osteopathic manifesto and is a reflection of the works of Goethe.
Post-American Civil War saw the formation of the Metaphysical Club; the most famous members were Oliver Wendell Holmes (1809-1894), William James (1842-1910), John Dewey (1859-1952) and Charles Pierce (1926-1999). Between these men arose the philosophy of pragmatism, knowing through doing, and the educational style of pedagogy, literally hands-on (Kuklick, 2001). Dr. Still knew of these men and kept company with their members.
William James, the psychologist, read Goethe on a summer convalescing in Germany from a bad back and was one of the most open minded to the new sciences. Menand, 2002, wrote:
He (James) used hypnotism regularly in his work as a psychologist... and publicly defended mind-cure practitioners, magnetic healers, Christian Scientists, and osteopaths when the Massachusetts Board of Health proposed a bill making it illegal to practice medicine without a licence.'
Osteopathy The Metaphysical Medicine
Why a metaphysical medicine? Metaphysics is attributed to Plato and his two-world approach. One world is the Real world of Ideas and Forms and the other world is that of the senses which is not to be trusted. The other approach to metaphysics is that of Aristotle. For Aristotle has a two-fold world metaphysics. It is the Platonic approach that dominates today. Reading the work of Dr. Still in a Platonic way leads to contradiction. Read in the Aristotelian manner it leads to a dynamic poetic movement of thought. It is due to this Platonic approach that metaphysics is commonly confused with spiritualism.
Due to this Aristotelian approach the word "Osteopathy" is a metaphor. 'He (Dr. Still) always spoke in metaphors, he was hard to understand' (Booth, 1905) and 'Still's religious discourse was also a bit more rambling and inconsistent, which allowed his followers to read increasingly material meanings into his theories of medical etiology (Fuller, 1989). The nineteenth century natural philosophers/ scientists saw bone as the last tissue to degenerate after death; therefore, it was the most harmonious with nature. To read the form of the bones is to come into direct sympathy/ empathy with nature, hence the word pathology (Walls, 1995). This is a primal understanding developed by Goethe, calling it the Urphanomen. Dr. Still was well aware of this naturphilosophie approach. As Booth, 1905 wrote, 'Primal nature was an essential environment for the independence necessary to accomplish his (Dr. Still's) work." Without the Goethian-Stillian philosophy osteopathy has no meaning.
Recognition of bone as the central tissue reflecting Nature through mammals, including human kind, came directly from Goethe. The University of Jena (Friedrich-Schiller-Universitat) houses Goethe's collection of bones, including skulls with arrows showing the direction of cranial movement. It is because of the Goethian word morphology that Dr. Still has his head held back while looking at the femur; it is the total form he is trying to take in. As Dr. Still said, 'I wanted to call my science osteopathy, and I did not care what Greek scholars said about it' (Booth, 1950). Osteopathy does not mean bone-disease. For Dr. Still "Osteo" was the form of Nature to be read, in a "pathy" or sympathetic/ empathetic mode of consciousness.
Osteopathy, as a philosophy, would use a psychology similar to William James; this is published by Dr. John Martin Littlejohn in Lectures in Psychophysiology, 1899. And here Littlejohn criticises the mind-in-the-brain movement and mentions the famous Phineas Gage. This is combined with the hands and is based on the surgical (meaning handcraft) approach to health as a first hand experience participating with the patient. This is why Dr. Still said, "anatomy, anatomy, anatomy." Today osteopathy has been reduced to a second hand objective-subjective biomedical-biomechanical treating the body as a dead machine. Hence the word soma from sema meaning coffin, grave or tomb for the soul.
Osteopathy is not yet dead, as some have professed. It is alive, well and sleeping in every osteopath. All that needs to take place is a formal teaching of the Goethian-Stillian philosophy of science in health care. It is the mode of consciousness and the worldview of the osteopath that makes osteopathy a philosophy and a physician centered health care system. The word physician means to return to normal and is participation between practitioner and patient. This is why osteopathy is a complete system.
Lastly, be aware of osteopaths selling quantum mechanics as a philosophy of osteopathy. This is a Platonic two-world experience of waves and particles.
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Booth, E. R. (1905) History of Osteopathy and Twentieth Century Practice. The Caxton Press, Cincinnati, Ohio.
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Walter Llewellyn McKone, DO, is Senior clinical practitioner, the children's clinic, the British School of Osteopathy, London, U.K.; member of the International Society for Philosophers, based at the Department of Philosophy, Sheffield University, Sheffield, U.K., his interest is in metaphysics; author of Osteopathic Medicine: Philosophy, Principles and Practice, 2001, published by Blackwell, Oxford and his forthcoming work is The Metaphysical Medicine: The Rise and Fall of American Medical Reformation. Founder of the Osteopathic Philosophical Society at http://www.osteopathicphilosophy.com.
© Walter Llewellyn McKone 2004