The DOs: Osteopathic Medicine in America, 2nd Ed.

Notes

1. Andrew Taylor Still

1. Andrew Taylor Still, The Autobiography of Andrew Taylor Still (Kirksville, Mo.: by the author, 1908), p. 18.

2. For an extended description and analysis of the circuit system see William Sweet, Methodism in American History (Nashville: Abingdon Press, 1954), pp. 143–85.

3. Horace Bushnell quoted in Winthrop S. Hudson, American Protestantism (Chicago: University of Chicago Press, 1961), p. 92.

4. Still, Autobiography, pp. 18, 19–21.

5. Sweet, Methodism, p. 158.

6. Roy Nichols, “The Kansas-Nebraska Act: A Century of Historiography,” Mississippi Valley Historical Review 48 (1956): 187–212.

7. Still, Autobiography, p. 76. Also see Thomas Goodrich, Wizr to the Knife: Bleeding Kansas, 1854–1861 (Mechanicsburg, Pa.: Stackpole Books, 1998).

8. D. W. Wilder, The Annals of Kansas (Topeka: Kansas Publishing House, 1886), pp. 409–11; Still, Autobiography, pp. 73–81.

9. Still, Autobiography, p. 76.

10. See William Norwood, Medical Education in the United States before the Civil Wizr (Philadelphia: University of Pennsylvania Press,

1944. and Martin Kaufman, American Medical Education: The Formative Years, 1765–1910 (Westport, Conn.: Greenwood Press, 1976). According to Thomas Bonner, the number of self-taught practitioners in Kansas was quite high: “In the heroic early years of Kansas medicine when settlers were scattered and doctors few, a doctor might almost be defined as anyone who was practicing medicine. No questions were asked if the practitioner brought relief from suffering. Frequently rough in dress and speech, half-literate, without formal training in medicine, the amateur physician was nevertheless on occasion a man of talents” (Thomas Bonner, The Kansas Doctor [Lawrence: University of Kansas Press, 1959], p. 11).

11. William Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopkins University Press, 1972), pp. 85–87.

12. The makeup of A. T. Still’s early medical library has not been completely settled. A letter dated October 29, 1943, from Dr. M. D. Warner, then dean of the Kirksville College, to American Osteopathic Association editor Ray Hulburt indicates that the school possessed a number of Still’s early books, including an unidentified 1845 dispensatory;Johannes Muller’s Elements of Physiology (Philadelphia: Lea and Blanchard, 1843); Robert Druitt’s Principles and Practice of Modern Surgery (Philadelphia: Lea and Blanchard, 1842); William Ferguson’s A System of Practical Surgery (London: J. Churchill, 1842); and Robert Harrison’s The Dublin Dissector (New York: S. S. and W Wood, 1858). In the intervening years many of these books have, unfortunately, disappeared from the school’s archives. However, two others have been discovered: Robley Dunglison’s The Practice of Medicine: A Treatise on Special Pathology and Therapeutics, vol. 2 (Philadelphia: Lea and Blanchard, 1844), and Samuel Cooper’s The First Lines of the Practice of Surgeiy, vol. 1 (New York: James and John Harper Printers, 1822).

13. Still, Autobiography, pp. 57, 84–85. In his colorful but wholly undocumented biography of his grandfather, Charles Still makes the remarkable and dubious claim that Andrew Still obtained the local Indian chief’s permission to disinter his tribe’s corpses to further his knowledge of anatomy. See Charles E. Still Jr., Frontier Doctor; Medical Pioneer: The Life and Times of A. T. Still and His Family (Kirksville, Mo.: Thomas Jefferson University Press, 1991) p. 23.

14. In a document dated December 17, 1877, pertaining to his application for an army pension, Still declared, “I was surgeon but the adjutant placed me on the roll as a hospital steward and I was paid as such. The whole reg[iment] will testify to the truthfulness of the statement. I did the duty of surgeon.” (Pension File of Andrew Taylor Still. Chicago, American Osteopathic Association Archives). See also Still, Autobiography, p. 186; Andrew Taylor Still, “Dr. Still’s Department,” Journal of Osteopathy (hereafter J Ost ) 7 (August 1900): 98–99.

15. The article was published in the Ladies’ Home journal in 1908 and republished in Concerning Osteopathy, ed. George Webster (Carthage, N.Y.: Cruikshank and Ellsworth, 1910), pp. 55–66. After the article appeared, a skeptical reader of the journal the Osteopathic Physician requested proof. Its editor, Henry Bunting, wrote for clarification to Still’s son-in—law, George Laughlin, who in turn asked A. T. Still. The latter thereupon corrected the details of the story. See “Asks If A.T. Still Ever Was a Real Doctor,” Osteopathic Physician (hereafter OP) 15 (January 1909): 8. For the first medical school established in Kansas City see Carrie Whitney, Kansas City, Missouri: Its History and People, 1808–1908, 2 vols. (Chicago: S.J. Clarke Publishing, 1908), 1:475.

16. Benjamin Rush, An Account of the Bilious Remitting Yellow Fever: As it Appeared in the City of Philadelphia, in the year 1793 (Philadelphia: Thomas Dobson, 1794). See also SaulJarcho, “John Mitchell, Benjamin Rush, and Yellow Fever,” Bulletin of the History of Medicine (hereafter Bull Hist Med) 31 (1957): 132–36.

17. See Lester King, Transformations in American Medicine: From Benjamin Rush to PVilliam Osler (Baltimore: Johns Hopkins University Press,

1991. pp. 1–65; Rothstein, American Physicians, pp. 45–49. As late as 1912 William Osler was still advocating the use of bloodletting in treating pneumonia. See his The Principles and Practice of Medicine, 8th ed. (New York: D. Appleton, 1912), pp. 99–100. According to Bonner, bloodletting was used quite extensively in Kansas throughout the 1850s, less so in the 1860s, and rarely in the 1870s. Bonner, Kansas Doctor, pp. 20–21. For the decline of bloodletting and heroic medicine nationally seeJohn Harley Warner, The Therapeutic Perspective: Medical Practice, Knowledge, and Identity in America, 1820–1885 (Cambridge: Harvard University Press, 1986).

18. See G. B. Risse, “Calomel and the American Medical Sects during the Nineteenth Century,” Mayo Clinic Proceedings 48 (1973): 57–64. Also Rothstein, American Physicians, pp. 50–60; Bonner, Kansas Doctor, p. 21.

19. Risse, “Calomel and American Medical Sects,” p. 58.

20. Still,Autohiography, p. 298.

21. Erwin Ackerknecht, “Aspects of the History of Therapeutics,” Bull Hist Med 36 (1962): 400–412.

22. Jacob Bigelow, A Discourse on Self-Limited Disease (Boston: Ticknor and Fields, 1854), p. 4.

23. Oliver Wendell Holmes, Medical Essays, 1842–1882 (Boston: Houghton Mifflin, 1892), p. 203.

24. See Bonnie Blustein, “Preserve The Love of Science”: Life of William A. Hammond, American Neurologist (New York: Cambridge University Press, 1991).

25. Bonner, Kansas Doctor, pp. 10–47, 23–30.

26. Andrew Taylor Still, “Dr. Still’s Department,” J Ost 6 (August 1899): 92–93. See also Bonner, Kansas Doctor, p. 21.

27. Still, Autobiography, pp. 87–88.

28. Ibid., p. 88.

29. For overviews of these movements see Norman Gevitz, ed., Other Healers: Unorthodox Medicine in America (Baltimore: Johns Hopkins University Press, 1988) and James Whorton, Nature Cures: The History of Alternative Medicine In America (New York: Oxford University Press, 2002).

30. See Samuel Thomson, The New Guide to Health (Boston: by the author, 1832); John Haller, The People’s Doctors: Samuel Thomson and the American Botanical Movement (Carbondale, Ill.: Southern Illinois University Press, 2000); Rothstein, American Physicians, pp. 125–51; Joseph Kett, The Formation of the American Medical Profession: The Role of Institutions, 1780–1860 (New Haven: Yale University Press,

1968. pp. 97–131.

31. Kett, Formation of the American Medical Profession, p. 23.

32. See Samuel Hahnemann, Organon of Homeopathic Medicine (New York: William Radde, 1849). For a critique of his approach in historical context see Norman Gevitz, “Unorthodox Medical Theories,” in Companion Encyclopedia of the History of Medicine, 2 vols. (London: Routledge, 1993) 1:603–33.

33. See Martin Kaufman, Homeopathy in America: The Rise and Fall of a Medical Heresy (Baltimore: Johns Hopkins University Press, 1972); Rothstein, American Physicians, pp. 152–73, 230–43, 294–301; For an insightful biography of its leading school see Naomi Rogers, An Alternative Path: The Making and Remaking of Hahnemann Medical College and Hospital of Philadelphia (New Brunswick, NJ: Rutgers University Press, 1998).

34. Holmes, Medical Essays, pp. ix—x.

35. Rothstein, American Physicians, pp. 237–39.

36. John Haller, Medical Protestants: The Eclectics in American Medicine, 1825–1939 (Carbondale: Southern Illinois University Press, 1994); Rothstein, American Physicians, pp. 217–29. Those botanic practitioners whose views were more similar to those of Thomson formed the smaller medical sect named physio-medicalism. See John Haller, Kindly Medicine: Physiomedicalism in America, 1836–1911 (Kent, Ohio: Kent State University Press, 1997).

37. See the table of students and graduates by sect, from 1850 to 1920, in Rothstein, American Physicians, p. 287.

38. Still, “Dr. Still’s Department,” J Ost 6 (August 1899): 92–93.

39. For the rise of temperance in Methodism, see Sweet, Methodism, pp. 171–72, 241–36. For temperance as a social phenomenon, see Joseph Gusfield, Symbolic Crusade: Status Politics and the American Temperance Movement (Urbana: University of Illinois Press, 1963), pp. 13–57.

40. Still,Autohiography, p. 83.

41. Richard Shryock, “Sylvester Graham and the Popular Health Movement, 1830–1870,” Mississippi Pulley Historical Review 18 (1931): 172–83;

178. For a more comprehensive view of Graham and others see James Whorton, Crusaders for Fitness: The History of American Health Reformers (Princeton: Princeton University Press, 1982).

42. Sylvester Graham, Lectures on the Science of Human Life, 2 vols. (Boston: Marsh, Capen, Lyon and Webb, 1839).

43. Marshall Scott Legan, “Hydropathy in America: A Nineteenth-Century Panacea,” Bull Hist Med 45 (1971): 274.

44. For more comprehensive portraits of hydropathy see Susan Cayleff, “l/Vash and Be H ealed”: The l/Vater- Cure Movement and Whmen ’s Health (Philadelphia: Temple University Press, 1986); andJane Donegan, “Hydropathic Highway to Health”: Women and Water-Cure in A ntehellum America (Westport, Conn.: Greenwood Press, 1986)

45. This story is related on pp. 195–201 of an unpublished, untitled manuscript by his sister Marovia Still Clark which is preserved in the archives of the Kirksville College of Osteopathic Medicine, Kirksville, Missouri.

46. For a brief discussion of those healers who employed stroking earlier, see Vincent Buranelli, The Wizard from Wenna: Franz Anton Mesmer (New York: Coward, McCann, and Geoghagen, 197 S ), pp. 17–25. One contemporary of Mesmer deserving of special mention was the American Elisha Perkins (1741–1799), who employed two metallic rods that he called tractors to perform similar cures. Believing that his discovery would benefit acute, infectious disease as well as nervous disorders, Perkins lost his life testing his theory during a yellow fever epidemic in New York. See Jacques Quen, “Elisha Perkins, Physician, Nostrum-Vendor or Charlatan?” Bull Hist Med 37 (1963): 159–66. For the continuing influence of Mesmer see Adam Crabtree, From Mesmer to Freud: Magnetic Sleep and the Roots of Psychological Healing (New Haven: Yale University Press, 1993).

47. Buranelli, Wizard from Vienna, pp. 59–132.

48. Report of Dr: Benjamin Franklin and Other Commissioners Charged… with the Examination of the Animal Magnetism (London: printed for L. Johnson, 1785); Buranelli, Wizard fi’om Vienna, pp. 157–68.

49. Report of the Magnetical Experiments Made by the Commission of the Royal Academy of Paris, Read on the Meetings ofj’une 21st and 28th, I 831, by Mr: Husson, the Reporter; trans. and intro. Charles Poyen (Boston: D. K. Hitchcock, 1836). James Braid, Neurypnology: Or the Rationale of Nervous Sleep: Considered in Relation with Animal Magnetism (Londoan. Churchill, 1843).

50. Eric Carlson, “Charles Poyen Brings Mesmerism to America,” journal of the History of Medicine (hereafterj Hist Med) 15 (1960): 121–32.

51. Charles Poyen, Progress of Animal Magnetism in New England (Boston: Weeks, Jordan, 1837); C. F. Durant, Exposition; or; A New Theory of Animal Magnetism (New York: Wiley and Putnam, 1837); W. L. Stone, Letter to Dr. A. Brigham on Animal Magnetism (New York: George Dearborne, 1837); A Gentleman from Philadelphia, The Philosophy of Animal Magnetism (Philadelphia: Merrihew and Gunn, 1837).

52. For a description of Quimby’s practice and differing accounts of his relative impact upon Eddy, see Frank Podmore, From Mesmer to Christian Science: A Short History of Mental Healing (New York: University Books, 1963), pp. 250–99; and Robert Peel, Mary Baker Eddy: The Years of Discovery, 1821–1875 (New York: Holt, Rineheart and Winston, 1966), pp. 146–338. See also Annetta Dresser, The Philosophy of RP. Quimhy (Boston: George Ellis, 1895); Mary Baker Eddy, Science and Health with Key to the Scriptures (Boston: First Church of Christ Scientist, 1971). For a recent account of ordinary Christian Science practitioners see Rennie Schoepflin, Christian Science on Trial (Baltimore: Johns Hopkins University Press, 2003).

53. Robert Delp, “Andrew Jackson Davis: Prophet of American Spiritualism,” Journal of American History 20 (1967): 43–57. See also S. E. D. Shortt, “Physicians and Psychics: Medical Response to Spiritualism,” J Hist Med 39 (1984): 339–55; and Edward M. Brown, “Neurology and Spiritualism in the 1870s,” Bull Hist Med 57 (1983): 563–77.

54. Andrew Jackson Davis, The Great Harmonia, 4 vols. (Boston: Benjamin Mussey,1853) 12325–30.

55. See John Teahan, “Warren Felt Evans and Mental Healing,” Church History 48 (1979): 63–80.

56. Warren Felt Evans, Mental Medicine (Boston: H. H. Carter, 1885) p. 109.

57. Edwin Dwight Babbitt, Vital Magnetism (New York: by the author, 1874). See also James Mack, Healing By Laying On of Hands (Boston, Colby and Rich, 1879) pp. 164–171, which contains Babbitt’s “Rules for Magnetizers.”

58. Banner of Light 36 (January 9, 1875): 8. This letter was an appeal for assistance on behalf of the people of Baldwin, who were suffering the effects of a grasshopper invasion. Written by Henry Durgin and co-signed by Still and three others, it noted, “There are a few workers here [spiritualists] but we are looked upon as ‘crazy’ and ‘worse than infidels’ and any calamity that may fall upon us is construed to be the just judgment of God, for our daring to think and act for ourselves.” See Carol Trowbridge, Andrew Taylor Still, 1828–1917 (Kirksville, Mo.: Thomas Jefferson University Press, 1991): 106–11. In 1903 Still attended a spiritualist meeting in Clinton, Iowa, whereupon he reported back to his students that the spiritualists’ views on drugging were similar to his own. Fanny Bennett and Ida Bush, “Dr AT Still’s Visit to the Spiritualists’ Meeting at Clinton, Iowa,” Bulletin of the Axis and Atlas Clubs 4 (September 1903): 3–6.

59. See in particular Andrew Taylor Still, Philosophy of Osteopathy (Kirksville, Mo.: by the author, 1899), pp. 44, 48, 57, 65.

60. Still, Autobiography, p. 182. Perhaps this idea stemmed from his training as an orthodox physician, for, as Bonner has noted of prewar Kansas practitioners generally, “From the books they had read and the medical colleges they had attended they viewed disease as largely the work of the blood” (Bonner, Kansas Doctor, pp. 21–22).

61. In her biography of Still, Carol Trowbridge attempts to connect the origin of his beliefs to the writings of evolutionary theorists. She believes that Still was directly indebted to Herbert Spencer’s First Principles (1859) and Principles of Biology (1866). However, these two books compared with Still’s four published volumes, are quite disparate in terms of epistemological foundations, methods of inquiry, data collection, use of source materials, cosmologic perspective, and subject matter. Also, in the brief passages of Still’s works where he alludes to evolutionary themes, Still’s thinking is muddled and he appears to have profited little by any of the notable evolutionary theorists he may have read. Furthermore, Spencer’s works have nothing remotely to do with palpatory diagnosis and manipulative treatment directed at the spine. See Trowbridge, Andrew Taylor Still.

62. Still,Autohiog’raphy, p. 108.

63. See E. M. Violette, History ofAdair County (Kirksville, Mo.: Journal Printing, 1911), p. 343. North Missouri Register, March 11, 1875. This notice ran in the Register until August of that year. From this time forward Still does not appear to have used the newspapers for advertising purposes.

64. Nine years later he registered as a physician and surgeon in Adair County. Photos of his certificates are printed in Arthur Hildreth, The Lengthening Shadow of Andrew Taylor Still (Kirksville, Mo.: Journal Printing, 1942), pp. 294–95.

65. Still, Autobiography, p. 112. Pension File of Andrew Taylor Still.

66. E. R. Booth, Histoiy of Osteopathy and Twentieth-Century Medical Practice (Cincinnati: Caxton Press, 1924), pp. 505–6.

67. Dr. Percival Potts said of his famous eighteenth-century bonesetting contemporary “Crazy Sally” Mapp, “Even the absurdities and impracticality of her own promises and engagements, were by no means equal to the expectations or the credulity of those who ran after her, that is, of all ranks and degrees of people from the lowest laborer up to those of the most exalted rank and station, several of whom not only did not hesitate implicitly to believe the most extravagant assertions of this ignorant, drunken, female savage, but even solicited her company or at least seemed to enjoy her society” (Quoted in C. J. S. Thompson, The Quacks of Old London [London: Brentano, 1928], p. 303).

68. James Paget, “Cases That Bonesetters Cure,” British Medical journal 1 (January 5, 1867): 1–4.

69. Wharton Hood, 0n Bonesetting, So—Called, and Its Relation to the Treatment offoints Crippled hy Injury (London: Macmillan, 1871), pp. 4, 26–27.

70. Ibid., pp. 149, viii.

71. Robert J. T. Joy, “The Natural Bonesetters, with Special Reference to the Sweet Family of Rhode Island,” Bull Hist Med 28 (1965): 416–41.

72. Douglas Graham, A Practical Treatise on Massage: Its History, Mode of Application, and Effects (New York: William Wood, 1884), p. 20.

73. Some bonesetters were apparently active in and around Missouri during this era. One MD wrote of an individual claiming to be one of the Rhode Island Sweets working his trade in his near neighborhood. See A. J. Steele, “The Osteopathic Fad,” Transactions of the Medical Association of the State of Missouri (1895): 343–58.

74. Still, Autobiography, pp. 100–101.

75. Homer Bailey quoted in Booth, History of Osteopathy, p. 32. See also Hildreth, Lengthening Shadow, p. 382.

76. Examples in Still’s approach to public speaking can be found in his Autobiography. See pp. 153–66, 177–81.

77. Harry Still quoted in Booth, History of Osteopathy, p. 57.

78. J. O. Hatten quoted in ibid., pp. 61 -62. For a patient’s narrative of Still’s work in the 1880s, see the interview with George Compton in the Kirksville Graphic, March 19, 1897, reprinted in} Ost3 (March 1897): 7–8.

79. Henry Bunting, “How Osteopathy Got Its First Recognition in Kirksville,” J Ost 5 (1899): 473–75; Hildreth, Lengthening Shadow, pp. 13–15, 371.

80. Hildreth, Lengthening Shadow, p. 26.

81. Andrew Taylor Still, “Dr. Still’s Department,” J Ost 8 (1901): 68.

2. The Missouri Mecca

1. See E. R. N. Grigg, “Peripatetic Pioneer: William Smith, MD, DO (1862–1912),” J Hist Med 22 (1967): 169–79; “Dr. William Smith, Pioneer at His Old Post,” GP 12 (July 1907): 15–16.

2. William Smith as quoted in E[amons] R. Booth, History of Osteopathy and Twentieth—Century Medical Practice (Cincinnati: Caxton Press, 1924), p. 448.

3. Arthur Hildreth, The Lengthening Shadow of Andrew Taylor Still (Kirksville, Mo.: Journal Printing, 1942), p. 31. The problem of securing sufficient material for dissection was an acute one for the remainder of the century. In 1897, Smith and his assistant Clarence Rider traveled to Chicago, where they were able to obtain unclaimed bodies by paying off attendants at the Cook County morgue. When the “heist” had been discovered and the participants named, a warrant for Smith’s arrest was issued. Fortunately, for Still’s anatomy instructor, the governor of Missouri refused to authorize his extradition and the matter was subsequently dropped. See “Dr. Clarence Rider Took Part in Stirring Pioneer Affairs,” 0P 8 (November 1905): 13.

4. For discussion of the size of the initial class, see Georgia Walter, The First School of Osteopathic Medicine (Kirksville, Mo.: Thomas Jefferson University Press, 1992), pp. 3–11. For an astute evaluation of Smith see Henry Bunting, “Dr. William Smith Died of Pneumonia in Scotland Feb. 15th after Two Days Illness,” 0P21 (March 1912): 1.

5. Henry Bunting, “The Real A.T. Still,” OP 32 (December 1917): 16.

6. Andrew Taylor Still, The Autobiography of Andrew Taylor Still, (Kirksville, Mo.: by the author, 1908), pp. 184–85.

7. Ibid. Still was fascinated by machinery, was an inventor, and repeatedly used his mechanical experience to illustrate his medical ideas. He had won a local prize in Baldwin for an improved butter churn, reputedly made a significant improvement to a reaper for which he received no credit, and as late as 1910 when he was 82 years old, was issued a US. patent for a “smokeless furnace.” A copy of this patent is printed in Charles Still, Frontier Doctor; Medical Pioneer: The Life and Times of AT Still and His Family (Kirksville, Mo.: Thomas Jefferson University Press, 1991): 232.

8. Hildreth, Lengthening Shadow, pp. 31–32, 194.

9. Andrew Taylor Still, “To Patients and Vlsitors,” J Ost 1 (August 1894): 2.

10. Andrew Taylor Still, “Important to Patients,” J Ost 2 (December 1895): 7; idem, “Address,” J Ost 1 (May 1894): 1; idem, “A Plea for Temperance,” J Ost 1 (June 1894): 1; idem, Autobiography, p. 276.

11. St. Louis Globe-Democrat, January 16, 1895, reprinted in J Ost 1 (January 1895): 8; Des Moines Daily News, November 10, 1895, reprinted in J Ost 2 (December 1895): 1;Nehraslea Daily Call, November 7, 1895, reprinted in J Ost 2 (December 1895): 4; 0ttumwa (Iowa) Press, n.d., reprinted in J Ost 1 (October 1894): 4; Bethany (Ill. ) Echo, n.d., reprinted in J Ost 1 (February 1895): 2.

12. “Volume Three,” J Ost 3 (June 1896): 4.

13. Kirksville Graphic, n.d., reprinted in J Ost 2 (September 1895): 2.

14. Loyal PVor/eman (Ottumwa, Ia.), September 1, 1896, reprinted in J Ost 3 (October 1896): 1.

15. “A Glance Backward,” J Ost 4 (1898): 367–74, 384–86.

16. “Invalids from Twenty-One States: APatient Tells What He Saw at the Still Infirmary in Kirksville,” J Ost 3 (June 1896): 6. See also the article from Godey’s Magazine (October 1895) reprinted in J Ost 2 (October 1895): 3.

17. These cases were originally published in the Kirksville Journal, January 30, 1896, and reprinted in the J Ost 2 (February 1896): 3.

18. Cincinnati Commercial Tribune, September 25, 1896, reprinted in J Ost 3 (October 1896): 5. See also Hildreth, Lengthening Shadow, pp. 85, 129; Booth, History of Osteopathy, pp. 46, 99. Senator Foraker’s son died at the age of thirty-nine. See “Death of A. St. C. Foraker Recalls Early Osteopathic History,” Forum of Osteopathy (hereafter Forum of 051’) 5 (1931): 176.

19. P. F. Greenwood, “The Position Osteopathy Occupies under the Present State Law,” } Ost 1 (May 1894): 2.

20. “A Petition,” J Ost 1 (May 1894): 4.

21. Greenwood, “Position OSteopathy Occupies,” p. 2

22. A. J. Steele, “The Osteopathic Fad,” Transactions of the Medical Association ofthe State of Missouri (1895): 363.

23. “Sequel to ’The Osteopathic Fad,”’ J Ost 3 (October 1896): 7.

24. William Smith, “Four Years Ago,” J Ost 3 (September 1896): 6.

25. Steele, “Osteopathic Fad,” p. 356.

26. E. C. Pickler and C. M. T. Hulett quoted in Booth, History of Osteopathy, pp.75,493.

27. Excerpts from the first charter can be found in the newspaper article reprinted in Hildreth, Lengthening Shadow, p. 34. See also Minutes of the Board of Trustees of the American School of Osteopathy, 1892, mimeographed, American Osteopathic Association Archives, Chicago.

28. Andrew Taylor Still, “Editorial,” J Ost 3 (December 1896): 4.

29. See Booth, History of Osteopathy, p. 85.

30. “Legislative,” J Ost 3 (February 1897): 4; “Missouri in Line,” J Ost 3 (March 1897): 1.

31. “Missouri in Line,” p. l.

32. Ibid.

33. According to figures cited by E. M. Violette, the number of graduates per year jumped from 48 in 1897, to 136 in 1898, 185 in 1899, and 317 in 1900. See his History of Adair County (Kirksville: Journal Printing, 1911), p. 264.

34. This is most evident in the books they wrote, which were among the first texts of the school. See William Smith, Notes on Anatomy (Kirksville, Mo.: by the author, 1898); Carl McConnell, Notes on Osteopathic Therapeutics (Kirksville: by the author, 1898); Charles Hazzard, Principles of Osteopathy, 3rd ed. (Kirksville: Journal Printing, 1899); C. W. Proctor, A Brief Course in General Chemistry (Kirksville: by the author, 1898); idem, A Brief Course in Physiological Chemistry (Kirksville: by the author, 1898); and J. Martin Littlejohn, Physiology: Exhaustive and Practical, 2 vols. (Kirksville: Journal Printing, 1898).

35. See Richard Cyriax, “A Short History of Mechano-Therapeutics in Europe until the Time of Ling,” Janus 19 (1914): 178-88; as quoted, p. 183; pp. 189–204; as quoted, p. 225. For a popular history see Robert Calvert, The History of Massage: An Illustrated History From Around the Wbrld (Rochester Vt.: Healing Arts Press, 2002).

36. William Balfour, Illustrations of the Power of Compression and Percussion in the Cure of Rheumatism, Gout, and Dehility of the Extremities in Promoting Health_ and Longevity (Edinburgh: P. Hill, 1819);John Bacot, Observations on the Use and Abuse of Friction with Some Remarks on Motion and Rest, as Applicable to the Cure of Various Surgical Diseases (London: Callow and Wilson, 1822); William Cleoburey, A Full Account of the System of Friction asAdopted Grosvenor and Pursued with the Greatest Success in Cases of Contracted joints and Lameness from Various Causes (Oxford: Munday and Slatter, 1825); S. Weir Mitchell, Injuries of Nerves and Their Consequences (Philadelphia: J. B. Lippincott, 1872); idem, Fat and Blood:An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria, 8th ed. (Philadelphia: J. B. Lippincott, 1900). Mitchell noted, “It is many years since I first saw in this city general massage used by a charlatan in a case of progressive paralysis. The temporary results he obtained were so remarkable that I began soon after to employ it in locomotor ataxia, in which it sometimes proved a signal value, and in other forms of spinal and local disease” (Fat and Blood, p. 81).

37. William Murrell, Massage as a Mode of Treatment (Philadelphia: P. Blakiston, Son, 1886), pp. 38–40.

38. Douglas Graham, A Practical Treatise on Massage: Its History, Mode of Application, and Effects (New York: William Wood, 1884).

39. George Taylor, Massage: Principles and Practice of Remedial Treatment by Imparted Motion (New York: Fowler and Wells, 1884), p. 28.

40. Graham, Practical Treatise on Massage, p. 35.

41. See Edgar Cyriax, “Concerning the Early Literature on Ling’s Medical Gymnastics,” j’anus 30 (1926): 225–32; idem, Bihliographia Gymnastica Medica (n.p., 1909)

42. Hazzard, Principles of Osteopathy, p. 292.

43. See Murrell, Massage as Mode of Treatment, pp. 20–28.

44. See Francis Schiller, “Spinal Irritation and Osteopathy,” Bull Hist Med 45 (1971): 252–54.

45. See in particular Evans Riadore, A Treatise on the Irritation of the Spinal Nerves as the Source of Neroousness, Indigestion, Functional and Organic Derangements of the Principal Organs of the Body, and on the Modifying Influence of Temperament and Habits of Man over Diseases and Their Importance as Regards Conducting Successfully the Treatment of the Latter; and on the Therapeutic Use of Witter (London: J. Churchill, 1843); and William Griffin and David Griffin, Observations on the Functional Aflections of the Spinal Cord and Ganglionic System of Nemes in which Their Identity with Sympathetic, Neroouse and Irritative Diseases is Illustrated (London: Burgess and Hill, 1844).

46. John Hilton, On Rest and Pain: A Course of Lectures on the Influence of Mechanical and Physiological Rest on the Treatment of Accidents and Surgical Diseases, and the Diagnostic Value of Pain, 2nd ed. (New York: W. Wood, 1879).

47. Francis Schiller, noting the considerable number of works published on the subject of spinal irritation during the second and third quarters of the nineteenth century, has suggested that Still could hardly have been unaware of this doctrine. Schiller, however, was unable to marshal any hard evidence that spinal irritation had a direct influence upon Still’s theory, nor have I subsequently been able to uncover any new information that would show an incontrovertible link between them. See Schiller, “Spinal Irritation and Osteopathy,” pp. 250–66.

48. Hazzard, Principles of Osteopathy, pp. 8–13; J. Martin Littlejohn, Principles of Osteopathy (Chicago: by the author, 1902), pp. 2–8.

49. Walter Riese, A History of Neurology 1 (New York; MD Publications, 1959), pp. 131–36. See also J. M. D. Olmstead, Charles—Edouard Brown-Sequard: A Nineteenth Century Neurologist and Endocrinologist (Baltimore: Johns Hopkins Press, 1946)

50. Hazzard, Principles of Osteopathy, pp. 35–51.

51. See William Bulloch, The History of Bacteriology (New York: Dover Publications, 1979).

52. Andrew Taylor Still, “Smallpox,” Bulletin of the Atlas and Axis Cluhs, no. 3 (1901): pp. 6–7.

53. See James Littlejohn, “Bacteriology: Its History and Relation to Disease,” J Ost 5 (1898): 130–34; David Littlejohn, “Diseases of a Pathogenic Origin: Indications for Treatment from an Osteopathic Standpoint,” J Ost 5 (1898): 177–80; and Carl McConnell, The Practice of Osteopathy (Chicago: The Hammond Press, 1899).

54. For example, see Andrew Taylor Still, Philosophy of Osteopathy (Kirksville, Mo.: by the author, 1899), p. 12.

55. For more on the American School of Osteopathy see Walter, The First School of Osteopathic Medicine, pp. 1–147.

3. In the Field

1. “Graduates of the American School of Osteopathy,” J Ost 7 (1900): 244–48.

2. Andrew Taylor Still, “Dr. Still’s Department,” J Ost 8 (1901): 68.

3. “What is the Science of Osteopathy?” Cosmopolitan Osteopath 1 (November 1898): 10.

4. Therese Cluett, “The Amusing Side of Osteopathy,” Boston Osteopath 3 (May 1900): 90.

5. Herbert Bernard quoted in E[amons] R. Booth, History of Osteopathy and Twentieth—Century Medical Practice (Cincinnati: Caxton Press, 1924), p. 60.

6. “Why Should I Try Osteopathy?” Southern journal of Osteopathy 1 (November 1898): 325.

7. “Notice to Our Patrons,” Northern Osteopath 1 (March 1897): 6.

8. “Diseases Successfully Treated by Osteopathy,” Pennsylvania Journal of Osteopathy 1 (June 1899): 24.

9. “Diseases Treated,” New York Osteopath 1 (April 1898) 47.

10. “Testimonials: Why We Run Them,” Osteopathic Success 1 (February 1901); 16.

11. “Miscellaneous Cases Reported from the Field,” Popular Osteopath 1 (1899): 156.

12. W. L. Riggs, “Osteopathy in Acute Diseases,” Cosmopolitan Osteopath 2 (July 1899): 23.

13. A. L. Evans, “Quick Cures,” Popular Osteopath I (1899): 150–51.

14. Cluett, “Amusing Side of Osteopathy,” p. 90.

15. “Letters from Graduates,” J Ost 4 (1898): 444.

16. Philadelphia College and Infirmary of Osteopathy, Annual Announcement (1899), p. 16.

17. A. L. Evans, “Why Osteopathy is Popular,” Popular Osteopath 1 (January 1899): 15.

18. See “Is Osteopathy Dying Out? Have We Passed Our Zenith?” OP 14 (November 1908): 1.

19. See Booth, History of Osteopathy, pp. 170–71; Charles Still, “Establishing the Fact that Osteopathy Is a Science,” } Ost 4 (1898): 415–18.

20. “The Man Who Took Osteopathy to the Pacific,” OP 8 (June 1905): 13.

21. Booth, History of Osteopathy, pp. 179–80, 181–83.

22. Ibid., p. 193.

23. See discussion in ibid., pp. 162–201.

24. Ibid., pp. 191–92.

25. Ibid., pp. 106–7; Arthur Hildreth, The Lengthening Shadow of Andrew Taylor Still (Kirksville, Mo.: Journal Printing, 1942), p. 24.

26. As reprinted in W. Livingston Harlan, Osteopathy: The New Science (Chicago: by the author, 1898), pp. 58–59.

27. “North Dakota Grit,” j Ost 3 (February 1897): 1–2.

28. Albert Bigelow Paine, ed., Mark Twain’s Speeches (New York: Harper and Brothers, 1923) p. 233.

29. Albert Bigelow Paine, Mark Twain, A Biography, 3 vols. (New York: Harper and Brothers, 1912) 2:1087–88. For more on Twain and Osteopathy see M. M. Brashear, “Dr. Still and Mark Twain,” journal of the American Osteopathic Association (hereafter JAOA) 73 (1973): 67–71; and Carol Trowbridge, Andrew Taylor Still: 1828–1917 (Kirksville, Mo.: Thomas Jefferson University Press, 1991), pp. 189–93.

30. See Booth, History of Osteopathy, pp. 95–161.

31. Ibid., p. 163.

32. For a history of this process see William Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopkins University Press, 1972), pp. 298–326; Martin Kaufman, Homeopathy in America: The Rise and Fall of a Medical Heresy (Baltimore: Johns Hopkins University Press, 1972), pp. 141–73. For a comparison of these sects’ colleges with osteopathic schools after the turn of the century see Norman Gevitz, “The Fate of Sectarian Medical Education,” in Beyond Flexner: Medical Education in the Twentieth Century, ed. Barbara Barzansky and Norman Gevitz (Westport, Conn.: Greenwood Press, 1992), pp. 83–97.

33. These estimates are based on an examination of early alumni lists published by the colleges as well as statistics cited in Booth, History of Osteopathy, pp. 71–94.

34. Ibid., p. 87.

35. See, for example, the advertisement for the American College of Osteopathic Medicine and Surgery on the back cover of the journal of the Science of Osteopathy (hereafterj Sci Ost) 1 (December 1900).

36. For a contemporary critique of osteopathic colleges see C. M. Turner Hulett, “The Profession and the Schools,” j Sci Ost 1 (June 1900): 141–44.

37. “Osteopathy as a Profession,” Cosmopolitan Osteopath 1 (July 1898): 34.

38. Mason Pressly, “Osteopathy as a Business,” Northern Osteopath 2 (May 1898): 7–8.

39. “The Advantages of Osteopathy as a Study and a Profession,” Philadelphia journal of Osteopathy 1 (January 1899): 13.

40. “The Atlantic School of Osteopathy,” Pennsylvania journal of Osteopathy 1 (June 1899): 23.

41. “The Science of Osteopathy,” The Osteopath 1 (February 1897): 4.

42. This estimate is based upon available early alumni records of several of the colleges. Of 765 total graduates to date listed by the American School of Osteopathy in 1900, for example, 183 (23.9 percent) were women. See “Graduates of the American School of Osteopathy,” pp. 244–48. See also Mike Fitzgerald, “Women in History: Pioneers of the Profession,” Tbe DO 25 (1984): 67–71. For the struggle of women entering orthodox medical education see Mary Roth Walsh, “Doctors I/Vantea’, No Wbmen Need Apply”: Sexual Barriers in tbe Medical Profizssz’on, 1835–1975 (New Haven: Yale University Press, 1977).

43. Lawrence Finn, “The Location of the Southern School and Infirmary,” Soutbern journal of Osteopathy 1 (February 1898): 13.

44. “Editorial,” Tbe Osteopatly 2 (August 1898): 13–14.

45. “Advantages of Des Moines—Disadvantages of Kirksville,” Cosmopolitan Osteopatb 1 (August 1898): 36–37.

46. Elmer Barber, Osteopathy: Tbe New Science of Healing (Kansas City: Hudson-Kimberly Publishing, 1896). Also see his Osteopatby Complete (Kansas City: Hudson-Kimberly Publishing, 1898).

47. When Smith temporarily left the American School of Osteopathy for private practice after completion of the first class, his teaching duties were taken over by Jenette “Nettie” Bolles (died 1930), one of his students who had previously earned two bachelor’s degrees. The third class in anatomy was conducted by Summerfield Still (1851-1931), the founder’s nephew. Each was to found a school; the former with her husband established the Bolles Institute of Osteopathy in Denver, and the latter set up the S. S. Still College of Osteopathy in Des Moines.

48. For details of the Kansas City case, see Booth, History of Osteopathy, pp. 86–87,166–67.

49. See E. M. Violette, History of Adair County (Kirksville, Mo.: Journal Printing, 1911), pp. 274–75.

50. For details see “Columbian School of Osteopathy, Medicine and Surgery,” Columbian Osteopatb 2 (October 1899): 263, 265; Violette, Histo1y of Adair County, p. 275.

51. J. R. Musick, “Is Osteopathy of Greek Origin?” J Ost 5 (1898): 221–25.

52. Andrew Taylor Still, “Dr. Still’s Department,” J Ost 5 (1898): 167, idem, “Medical Osteopathy,” J Ost 8 (1901): 166.

53. “Cofounder of First Osteopathic College Dies,” I/Vestern Osteopath 23 (1929): 19.

4. Structure and Function

1. C. M. Turner Hulett, “Historical Sketch of the AAAO,” JAOA 1 (1901): 1–6; “Proceedings of the Fifth Annual Meeting of the American Association for the Advancement of Osteopathy,” JAOA 1 (1901): 6–15.

2. “Constitution of the American Osteopathic Association,” JAOA l (1901): 16–17.

3. “Constitution and By—Laws,” JAOA 9 (1909): 37–43. See also “Should the By-Laws Be Changed?” JAOA 11 (1911): 667—-71.

4. “Preliminary Report of the A.O.A. Committee on By—Laws,” JAOA 18 (1919): 304–8; W. A. Gravett, “The New AOA,” _7AOA 19 (1920): 191–93.

5. E[amons] R. Booth, History of Osteopathy and Twentieth-Centuiy Medical Prac+ tice (Cincinnati: Caxton Press, 1924), pp. 106–8; A. L. Evans, “Legal Status of Osteopathy in the Various States,” JAOA 2 (1903): 145–47.

6. Chester Cole, “Iowa’s Medical Board and Osteopathy Law,” Cosmopolitan Osteopath 2 (March 1899): 3–4; “Osteopathic Victory in Iowa,” JAOA 1 (1902): 162–63.

7. See A. G. Hildreth, “Report of the Committee on Legislation with Bill Appended,” JAOA 5 (1905): 71–75; idem, “Osteopathic Legislation,” JAOA 2 (1903): 143–44.

8. Samuel Baker, “Physician Licensure Laws in the United States, 1865–1915 ,” j’Hist Med 39 (1984): 173–97. See also William Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimorezjohns Hopkins University Press, 1972), pp. 305–10.

9. A. G. Hildreth, “Osteopathic Legislation,” JAOA 4 (1905): 191.

10. American Osteopathic Association, IEarhoole and Directoiy (Chicago, 1913), pp. 97–108; American Osteopathic Association, Rarhoole and Directory (Chicago, 1923), pp. 169–89.

11. Hulett, “Historical Sketch of the AAAO,” p. 2.

12. Booth, Histoiy of Osteopathy, pp. 272–77.

13. “Constitution of the American Osteopathic Association,” p. 16.

14. Wilfred Harris, “The Three Year Course: Some Questions for the Profession to Decide,” JAOA 3 (1904): 373.

15. “Report of the AOA Committee on Education,” JAOA 2 (1902): 10–19.

16. C. M. Turner Hulett, “The Profession and the Schools,” J Sci Ost 1 (June 1900): 144.

17. Martin Littlejohn, “The Standard of Education,” JAOA 1 (1902): 191–93. For more on the Littlejohn brothers and the Chicago school see Theodore Berchtold, 7?) Each, 7?) Heal, 7?) Serve (Chicago: Chicago College of Osteopathic Medicine, 1975).

18. Eamons Booth, “Report of Inspector of Osteopathic Schools,” JAOA 3

1903. supplement: 9–20.

19. “Proceedings of the Eighth Annual Meeting of the American Osteopathic Association,” JAOA 4 (1904): 38, 51.

20. Philadelphia College and Infirmary of Osteopathy and the Osteopathic Hospital of Philadelphia, Annual Announcement (1919), p. 11.

21. Chicago College of Osteopathy, Annual Catalog (1913), pp. 15–16.

22. “Proceedings of the Philadelphia Meeting,” JAOA 13 (1914): 727.

23. Henry Bunting, “Let Us Discuss Our Failures with Each Other,” 0P (July 1902): 1–2.

24. “Case Reports,” JAOA 4 (1904): 96–98, 100–101.

25. A textbook based heavily upon these supplements was later issued. See Carl McConnell, ed., Clinical Osteopathy (Chicago: A. T. Still Research Institute, 1917).

26. See Edythe Ashmore, ed., “Case Reports,” JAOA 3 (February 1904) supplement: 1-40. In the same journal: 3 (June 1904) supplement: 1–34.; 4 (March 1905) supplement: 1–36; 4 (August 1905) supplement: 1–32; 5 (July 1906) supplement: 1–40; 6 (June 1907) supplement: 1–48; 7 (September 1907) supplement: 1–45; 7 (June 1908) supplement: 1–47; 7 (August 1908) supplement: 1–48; 8 (June 1909) supplement: 1—-53; 8 (July 1909) supplement: 1–48; 8 (August 1909) supplement: 1–46.

27. See Fred Bischoff and Ray Hulbert, “The A. T. Still Research Institute: An Historical Sketch and A Look Ahead,” JAOA 25 (1926): 376–77.

28. See John Deason and L. G. Robb, “On the Pathways for the Bulbar Respiratory Impulses in the Spinal Cord,” American journal of Physiology 28 (1911): 57——63.

29. See John Deason and associates, Research in Osteopathy (Chicago: A. T. Still Research Institute, 1916).

30. Barbara Peterson, “Louisa Burns, DO: Pioneer Researcher,” The DO 18 (July 1978): 21–22.

31. A summary of Burns’s work is to be found in Louisa Burns and associates, Pathogenesis of Visceral Disease following Vertebral Lesions (Chicago: American Osteopathic Association, 1948).

32. For a more favorable assessment of Burns’s research by a collaborator late in her career see Wilbur V. Cole, “Louisa Burns Memorial Lecture,” JAOA 69 (1970): 1005–17.

33. “Improper Advertising,” JAOA 2 (1902): 85–86; JAOA 3 (1903): 58–59.

34. “Code of Ethics of the American Osteopathic Association,” JAOA 4 (1904): 92–96; 95.

35. “Osteopaths Frame Code of Ethics,” OP 3 (December 1902): 1–2.

36. “Code of Ethics of the American Osteopathic Association,” p. 95.

37. “Report of the Committee on Education to the Board of Trustees of the American Osteopathic Association,” JAOA 7 (1907): 87.

38. Henry Bunting, The Elementary Laws of Advertising (Chicago: Novelty News Press, 1914).

39. Data derived from American Osteopathic Association, Yearbook and Directory (Chicago, 1918); American Osteopathic Association, léarhook and Directory (Chicago: 1930).

40. “Hard to Distinguish Wolves When They Break into the Fold,” OP 2 (July 1902): 1; “What We Do to Fakers in New York,” OP 5 (May 1904): 12.

41. S. C. Matthews, “The Fake Osteopath,” The American Osteopath 2 (September 1900): 9. See alsoJoseph Sullivan, “Retrospective,” The American Osteopath 1 (June 1900): 216; W L. Riggs, “Opposition to the Growth of Osteopathy,” Cosmopolitan Osteopath 3 (September 1899): 3.

42. C. M. Turner Hulett, “Correspondence Schools,” JAOA 1 (1902): 149.

43. “Report of the Committee on Education to the Board of Trustees of the American Osteopathic Association,” JAOA 7 (1907): 87.

44. Chittenden Turner, The Rise of Chiropractic (Los Angeles: Powell Publishing, 1931), pp. 11–16.

45. Ibid., pp. 26–34; Ralph Lee Smith, At lbnr Own Risk: The Case against Chiropractic (New York: Trident Press, 1969), pp. 1–13.

46. Smith, At lfiur Own Risk, pp. 8–11; Turner, Rise of Chiropractic, pp. 35–45.

47. Edythe Ashmore, “An Imitation and Its Lessons,” JAOA 7 (1908): 209–11, 310–11.

48. Turner, Rise of Chiropractic, pp. 95, 294.

49. For recent comprehensive histories of chiropractic see J. Stuart Moore, Chiropractic in America: The History of a Medical Alternative (Baltimore: Johns Hopkins University Press, 1993); and Walter Wardwell, Chiropractic: History and Evolution of a New Profession (St. Louis: Mosby Year Book, 1992).

5. Expanding the Scope

1. Minutes of the Board of Trustees of the American School of Osteopathy, 1892; mimeographed, American Osteopathic Association Archives, Chicago.

2. Andrew Taylor Still, “Dr. Still’s Departrnent,” } Ost 8 (1901): 67.

3. Completed American Osteopathic Association School Questionnaires for the academic year 1903–4, microfilmed, American Osteopathic Association Archives, Chicago.

4. Data derived from American School of Osteopathy, Annual Catalog (1908), pp. 24–26; American School of Osteopathy, Annual Catalog (1918), pp. 66–68; Los Angeles College of Osteopathy, Annual Catalog (1908), p. 30; College of Osteopathic Physicians and Surgeons, Annual Catalog (1918), pp. 17–18; Philadelphia College and Infirmary of Osteopathy and the Osteopathic Hospital of Philadelphia,AnnualAnnouncement(1918), pp. 21–25; Littlejohn College and Hospital, Bulletin and journal of Health, Announcement Number (1909), p. 15; Chicago College of Osteopathy, Annual Catalog (1918), p. 19.

5. See Raymond Ward, “Why Some Osteopaths Study at Medical Colleges,” OP 31 (January 1917): 25–27.

6. D. V. Moore, “Obstetrics and the General Practitioner,” JAOA 16 (1917): 1197–98.

7. Central College of Osteopathy, Annual Announcement (1906), p. 16.

8. Lillian Whiting, “Can the Length of Labor Be Shortened by Osteopathic Treatment?”}AOA_11 (1912): 917–21.

9. Harry Collins, “Origin and Progress of Osteopathic Surgery,” JAOA 23 (1924): 715–16.

10. George Still, “Advantages and Necessity of Osteopathic Post-Operative Treatment,” JAOA 18(1919): 485.

11. See Frank Young, Surgery fi’om an Osteopathic Standpoint (Kirksville, Mo.: Journal Printing, 1904); S. L. Taylor, “Borderline Cases between Surgery and Osteopathy,” JAOA 12 (1912): 148–54; James Littlejohn, “Indications for Surgical Interference in Gynecological Cases,” JAOA 12 (1913): 331–36; “Dr. George A. Still Calls Case Reports the Profession’s Most Vital Problem,” OP 24 (November 1913): 3–5.

12. [Andrew Taylor Still], “Our Platform,” 5’ Ost 9 (October 1902): 342, later reprinted in Andrew Taylor Still, Osteopathy: Research and Practice (Kirksville, Mo.: by the author, 1910), pp. 4–5.

13. Dain Tasker, “The ‘Lesion’ Osteopath is Too Narrow,” OP 3 (January 1903): 3.

14. “‘Lesions’ and ‘Adjuncts’: The Discussion Which Occurred at Cleveland on This Subject,” JAOA 3 (1904): 280, 283.

15. Ibid., pp. 285–88.

16. Carl McConnell, The Practice of Osteopathy (Chicago: Hammond Press, 1899); idem, “A Few Thoughts for the Osteopathic Practitioner,” J Ost (January 1901): 9.

17. See C. W. Young, “Digest of Answers to Twelve Questions,” JAOA 8 (1909): 358–60, 435–38. This was a survey of 260 DOs on the subjects of diet, water, and “thought direction,” as well as how broad osteopathy should be.

18. William Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopkins University Press, 1972), pp. 177–97.

19. See Merck and Company, Manual of Therapeutics and Materia Medica: A Source of Ready Reference for the Physician (Rahway, N.J., 1899).

20. See Hubert Lechevalier and Morris Solotorovsky, Three Centuries of Microhiology (New York: Dover Books, 1974).

21. In a commentary upon the smallpox vaccination, Still declared, “I would not antagonize the popular belief in the efficacy of vaccination but do most emphatically combat the insertion into the human body of putrid flesh of any animal” (Still, Osteopathy: Research and Practice, p. 456).

22. Ibid., pp. 300–301,433–35,470–72.

23. [Still], “Our Platform,” p. 342. There was one exception, however. Still believed that a periodic application of a cantharidin blister to the arm would serve as a safer and more effective preventative against smallpox than vaccination: “My theory is, that the first active occupant of the body by an infectious fever will drive off others and hold possession of the body until its power is spent” (Andrew Taylor Still, “Smallpox: Cantharidin as a Germifuge,” J Ost 9 [February 1902]: 69).

24. [Andrew Taylor Still], “What Will Become of the MD-DO?” J Ost 10 (November 1903): 366.

25. W. A. Hinckle, “A Protest against Intellectual Tyranny,” OP 7 (March 1905): 11–12.

26. Some DOs denied the validity of such studies. Said Dr. Riley Moore, “We as a profession have a few who, trusting blindly in claims made by medical authors and not knowing that medical statistics can be juggled to prove anything profitable, believe in such practice [vaccination]. But it seems to me that those who do have failed to grasp the proper conception of osteopathic principles” (Riley Moore, “Vaccination: Osteopaths Ought to Read up on It,” OP 13 [January 1908]: 4).

27. “Correspondence,” JAOA 8 (1908): 90–91.

28. Charles Teall, “Report of the Inspector of Schools,” JAOA 6 (October

1906. supplement: 18–25.

29. E. S. Comstock, “The Littlejohn College Idea,” JAOA 11 (1911): 675–76; “A Letter from Dr. Littlejohn,” JAOA 11 (1911): 727–29.

30. A. B. Shaw, “The California Law and Its Workings,” JAOA 13 (1914): 283–84; “Report of the Committee on Education,” JAOA 12 (1913): 746–47; Dain Tasker, “Notes on Medical Legislation in California,” JAOA 15 (1916): 398–404.

31. Teal J, “Report of the Inspector,” pp. 19–20.

32. Des Moines Still College of Osteopathy, Annual Catalog (1908), p. 50.

33. American School of Osteopathy, Annual Catalog (1911), p. 35.

34. “The Message from Philadelphia,” JAOA 13 (1914): 720–24.

35. “New Legislation in Oregon Causes Dissension,” GP 26 (March 1915): 8–9.

36. Henry Bunting, “What is Materia Medica Anyway? How Far Are We Against It?” GP 27 (June 1915): 5–6.

37. “Sentiment in Oregon Divided on New Law,” GP 28 (July 1915): 9.

38. As reprinted in E[amons] R. Booth, History of Osteopathy and Twentieth-Century Medical Practice (Cincinnati: Caxton Press, 1924), p. 442.

39. “Espousing Academic Freedom Was the Most Notable Work of the Portland Convention,” OP 28 (August 1915): 1–3.

40. Alfred Crosby, Jr., Epidemic and Peace (Westport, Conn.: Greenwood Press, 1976), pp. 206–7. See also A. A. Hoehling, The Great Epidemic (Boston: Little, Brown, 1961); and Gina Kolata, Flu: The Story of the Great Influenza Pandemic and the Search for the Virus That Caused It (New York: Farrar, Strauss and Giroux, 1999)

41. William Osler, Principles and Practice of M edicine, 8th ed. (New York: D. Appleton, 1912), p. 119.

42. Carl McConnell, “Editorial: The Treatment of Influenza,” JAOA 18 (1918): 83–85; C. C. Reed, “Prevention and Treatment of Influenza,” JAOA 181 (1919): 209–11; L. K. Tuttle and Robert Rogers, “Influenza and Pneumonia Treatment,” JAOA 18 (1919): 211–14; George McCole, “Spanish or Epidemic Influenza from the Treatment Side,” GP 35 (June 1919): 1–6.

43. Norman Gevitz, “The Sword and the Scalpel: The Osteopathic War to Enter the MilitaryMedical Corps: 1916–1966,” JAOA 98 (1998): 279–86.

44. “Osteopathy’s Epidemic Record,” GP 36 (July 1919): 1; “Death Statistics Reveal Comparative Values of Osteopathic and Drug Treatments,” GP 34 (December 1918): 1–2.

45. “Editorial: Figures Never Lie,” jAlVIA 72 (1919): 731.

46. “The Profession’s Policy,” JAOA 19 (1920): 482–83; “Report of the Associated Colleges,” JAOA 19 (1920) supplement: 6–7.

47. As of 1927 only eleven states gave DOs the same unlimited license privileges granted to MDs. See American Osteopathic Association, Digest of State Laws Relating to Osteopathy (Chicago, 1927).

48. E. S. Comstock, “A Professional Problem,” JAOA 23 (1924): 524; idem, “Chicago College Curriculum,” JAOA 24 (1925): 460; Asa Willard, “Materia Medica in the Colleges,” JAOA 25 (1925): 279.

49. George Carpenter, “Between the Devil and the Deep Blue Sea, or Damned If We Do and Damned If We Don’t,” Forum of Ost 2 (December 1928): 3–4.

50. “Proceedings of the House of Delegates,” Forum of Ost 3 (August

1929. supplement: 5.

51. “Correspondence: Materia Medica,” Forum of Ost 2 (October 1928): 14–15; and Forum of Ost 2 (November 1928): 10–11; H. L. Knapp, “An Open Letter to Dr. John A. MacDonald,” Forum of Ost 2 (December 1928): 3; Warren Davis, “People Want Osteopathy,” Forum of Ost 2 (February 1929): 7.

52. “Proceedings of the House of Delegates,” Forum of Ost 3 (August

1929. supplement: 6.

53. “Proceedings of the House of Delegates,” Forum of Ost 4 (October

1930. supplement: 6–8.

6. The Push for Higher Standards

1. See Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982) pp. 102-16.

2. John Field, “Medical Education in the United States: Late Nineteenth and Twentieth Centuries,” in The History of Medical Education, ed. C. D. O’Malley (Berkeley: University of California Press, 1970), pp. 508–9. See also V. Johnson and H. G. Weiskotten, A History of the Council on Medical Education and Hospitals of the American Medical Association (Chicago: American Medical Association, 1960).

3. Abraham Flexner, Medical Education in the United States and Canada:A Report to the Carnegie Foundation for the Advancement of Teaching (Boston: Merrymount Press, 1910), pp. 62–67, 91–103.

4. Ibid., p. 151.

5. See Kenneth Ludmerer, Learning to Heal: The Development of American Medical Education (New York: Basic Books, 1985), pp. 173–90; William Rothstein, American Medical Schools and the Practice of M edicine (New York: Oxford University Press, 1987) pp. 142–49.

6. There were 95 MD-granting schools in the United States in 1915; 85 in 1920; and 71 in 1927. See Morris Fishbein, A History of the American Medical Association, 1847 to 1947 (Philadelphia: W. B. Saunders, 1947), p. 898.

7. H. G. Weiskotten et al., Medical Education in the United States, 1934 to 1939 (Chicago: American Medical Association, 1940), p. 15.

8. Ibid., pp. 67, 107.

9. Sauljarcho, “Medical Education in the United States, 1910–1956,” journal of the Mount Sinai School of Medicine 26 (1957): 351; Field, “Medical Education,” pp.512–13.

10. Of the 5,611 MDs graduating in 1935, 5,491 (98 percent) immediately entered approved internships. See “Medical Education in the United States and Canada: Data for the Academic Year 1935–36,” JAMA 107 (1936): 669.

11. Minutes of the December 28, 1908 meeting of the AMA Council on Medical Education, Archives of the American Medical Association, Chicago. See Norman Gevitz, “The Fate of Sectarian Medical Education” in Beyond Flexner: Medical Education in the Twentieth Century, ed. Barbara Barzansky and Norman Gevitz (Westport, Conn.: Greenwood Press, 1992), pp. 83–97.

12. Flexner, Medical Education, p. 164.

13. Ibid., pp. 164–66.

14. Ibid., p. 166.

15. “Carnegie Foundation Report,” JAOA 10 (1911): 621–22.

16. “Report of the Committee on Education,” JAOA 10 (1910): 35–38.

17. John Rogers, “Report of the Committee on College Instruction,” JAOA 31 (1932): 509; Completed AOA Survey Questionnaires of Osteopathic Colleges for the academic year 1931–32, microfilmed, American Osteopathic Association Archives, Chicago.

18. George Laughlin, “Hindrances of Osteopathic Progress,” JAOA 24 (1925): 519. Upon Andrew Still’s death in 1917 his grandnephew George Still became president. A family struggle ensued, resulting in some members’ leaving the American School of Osteopathy. In 1922 Laughlin, an orthopedic surgeon, opened a rival school in Kirksville, the Andrew Taylor Still College of Osteopathy and Surgery. Upon George Still’s death that same year, negotiations were begun for the merger of the two institutions, which was effected in

1924. See E[amons] R. Booth, History of Osteopathy and Twentieth-Century Medical Practice (Cincinnati: Caxton Press, 1924), pp. 548–49; Georgia Warner Walter, The First School of Osteopathic Medicine (Kirksville, Mo.: ThomasJefferson University Press, 1992) pp. 93–164.

19. Laughlin, “Hindrances to Osteopathic Progress,” p. 519.

20. R. H. Singleton, “Report of Committee on American Osteopathic Foundation,” JAOA 31 (1932): 511. See also John Rogers, “Report of the Bureau of Professional Education and Colleges,” JAOA 36 (1937): 607.

21. See Asa VVlllard, “State Legal and Legislative Matters,” Forum of Ost 4 (October 1930) supplement: 12.

22. This school is not to be confused with the Central College of Osteopathy, also of Kansas City.

23. Carol Benenson Perloff, Yb Secure Merit: A Century of Philadelphia College of Osteopathic Medicine: 1899–1999 (Philadelphia: Philadelphia College of Osteopathic Medicine, 1999), pp. 22–27.

24. For example, see A. W. Bailey, “Osteopathic Education,” JAOA 24 (1925): 355–58.

25. “Medical Education in the United States and Canada: Data for the Academic Year 1935–36,” pp. 684–85.

26. Data derived from Completed AOA Survey Questionnaires of Osteopathic Colleges for the academic year 1935–36, microfilmed, American Osteopathic Association Archives, Chicago.

27. Data derived from college catalogs.

28. College of Osteopathic Physicians and Surgeons, Annual Announcement (1935), p. 71.

29. See John Wood, “Public Tax Supported Hospitals,” JAOA 50 (1951): 141–44.

30. George Woodbury, “Unit Number Two of the Los Angeles County General Hospital: What It Is and How It Came About,” LVestern Osteopath 23 (September 1928): 7–11.

31. Precisely how many osteopathic hospitals there were in this period is not known, since such institutions were under no obligation to identify themselves to the AOA. See Edgar Holden, “Report of the Bureau of Hospitals,” JAOA 35 (1935): 46.

32. John Rogers, “Report of Bureau of Professional Education and Colleges,” JAOA (1932): 508.

33. As derived from American Osteopathic Association, Abstract of Laws Governing the Practice of Osteopathy (Chicago, 1937), pp. 3–15.

34. Osteopathic data from “Report of the American Association of Osteopathic Examiners: 1952,” microfilmed, American Osteopathic Association Archives, Chicago; MD data derived from “Medical Education in the United States,” JAMA 90 (1928): 1203; JAMA 92 (1929): 1434–35; JAMA 94 (1930): 1312–13; JAMA 96 (1931): 1392–93; JAMA 98 (1932): 1460–61.

35. In 1907, 40.5 percent of all AOA-listed DOs were located in five states that had colleges: California, Illinois, Iowa, Missouri, and Pennsylvania. In 1940 this figure stood at 42.1 percent. Data derived from American Osteopathic Association, Yearbook and Directoiy (Chicago, 1940).

36. Norman Gevitz, “‘A Coarse Sieve’: Basic Science Boards and Medical Licensure in the United States,” J Hist Med 43 (1988): 36–63; and Robert Derbyshire, Medical Licensure and Discipline in the United States (Baltimore: Johns Hopkins Press, 1969), pp. 118–33.

37. As quoted in Asa Willard, “Basic Science Boards,” Forum of Ost 2 (November 1928): 2.

38. “State Board Statistics for 1930,” j’AA/IA 96 (1931): 1399.

39. Willard, “State Legal and Legislative Matters,” p. 13.

40. As quoted in Willard, “Basic Science Boards,” p. 3.

41. Frederick Etherington and S. Stanley Ryerson, “Preliminary Report to the Joint Advisory Committee Representing the College of Physicians and Surgeons of Ontario, the Ontario Medical Association, and the Universities in Ontario Engaged in the Teaching of Medicine on Osteopathic Colleges and Teaching in Kirksville, Philadelphia, Des Moines, and Chicago,” March 1, 1934, microfilmed, American Osteopathic Association Archives, Chicago.

42. See “Report of the Council on Medical Education and Hospitals,” JAMA 114 (1940): 1926.

43. See Ray Hulburt, “The Ontario Investigation of Osteopathy,” JAOA 34 (1935): 466—-71. Although the official report of Etherington and Ryerson was straightforward and factual, other statements by them tended to support the DOs’ charges of bias. See Frederick Etherington, “Osteopathy and Licensure,” JAMA 104 (1935): 1549–52.

44. L. E. Blauch, “Studies of the Chicago, Des Moines, Kansas City and Philadelphia Osteopathic Colleges,” 1936, microfilmed, American Osteopathic Association Archives, Chicago. Blauch’s Kirksville study is not included in the archival collection.

45. “Entrance Requirements, Enrollments, Next Steps,” JAOA 39 (1939): 225–26. In 1943 the AOA began enforcing a requirement that the matriculants had to already have taken a minimum number of courses in English, biology, physics, and chemistry. See R. McFarlane Tilley, “Report of the Bureau of Professional Education and Colleges,” JAOA 93 (1943): 81–83.

46. Asa Willard, “Where Our Students Come From,” JAOA 46 (1947): 313.

47. Lawrence Mills, “Colleges Visited,” JAOA 45 (1946): 422; JAOA 46 (1947): 591–92,

48. See Lawrence Mills, “Applications to Osteopathic Colleges,” JAOA 51 (1952): 541–42.

49. Lawrence Mills, “Osteopathic Education,” JAOA 50 (1951): 277–78.

50. Data derived from college catalogs.

51. Data derived from abstracted minutes of the sessions of the American Association of Osteopathic Colleges, 1945–60, microfilmed, American Osteopathic Association Archives, Chicago.

52. Data derived from college catalogs.

53. Data derived from Completed AOA Hospital Questionnaires for the year 1960, microfilmed, American Osteopathic Association Archives, Chicago.

54. Data derived from college catalogs.

55. “Osteopathic Progress Fund Reaches $962,535 as of June 15th,” JAOA 43 (1944): 527.

56. Figures derived from “Recap of Annual Cash Received by the Osteopathic Progress Fund, 1946–1975,” typescript, American Osteopathic Association Archives, Chicago.

57. “Cancer Teaching Grants to Osteopathic Colleges,” JAOA 51 (1951):

126. “Six Colleges Report USPHS Grants,” Forum of Ost 30 (1956):

127. “Hospital Survey and Construction Act,” JAOA 46 (1946): 24–26; “Important Change in Hospital Construction Act Regulations,” JAOA 46 (1947): 570.

58. See American Osteopathic Association, Standardization of Osteopathic Hospitals, Including Codes, Hospital Regulations, Requirements for YEacbing of Interns, 2nd ed. (Chicago: AOA, 1938).

59. R. C. McCaughan, “Report of the Executive Secretary,” JAOA 45 (1945): 23.

60. Floyd Peckham, “Report of the Bureau of Hospitals,” JAOA 51 (1951): 74.

61. “AOA History: Dates, Events, and People,” JAOA 77 (April 1978) supplement: 10.

62. R. McFarlane Tilley, “Report of the Advisory Board for Osteopathic Specialists,” JAOA 39 (1939): 74–75.

63. See R. C. McCaughan, “Report of the Executive Secretary,” JAOA 42 (1942): 46; R. McFarlane Tilley, “Report of the Bureau of Professional Education and Colleges,” JAOA 46 (1946): 75; JAOA 47 (1947): 78–79; JAOA 49 (1949): 57; JAOA 50 (1950): 76. Also see Robert Thomas, “Report of the Bureau of Professional Education and Colleges,” JAOA 53 (1953): 75. American Osteopathic Association, Abstract of Laws and Regulations Governing the Practice of Osteopathy (Chicago, 1960), p. 2.

7. A Question of Identity

1. Robert Thomas, “Report of the Council on Education,” jA OA 50 (1950): 88.

2. G. W. Woodbury, “The Treasure of Distinctive Osteopathy,” JAOA 39 (1940): 367.

3. E. A. Ward, “Pneumonia: Comparative Therapeutics,” JAOA 49 (1950): 318–20; Floyd Peckham, “How to Obtain Better Cooperation between the Profession and the Hospital,” JAOA 45 (1946): 199–200.

4. C. Robert Starks, “Our Greatest Challenge,” JAOA 45 (1946): 537.

5. Floyd Peckham, “Report of the Bureau of Hospitals,” jA OA 51 (1951): 74.

6. See Raymond Keesecker, “The Road Ahead for Osteopathy,” Forum of Ost 29 (1955): 283; Woodbury, “Treasure of Distinctive Osteopathy,” p. 367; Stanley Evans, “Future of Osteopathy,” Osteopathic Profession 15 (March 1948): 12.

7. See J. McKee Arthur, “The Editor’s Page,” Osteopathic Profi’ssion 9 (1942): 28–29.

8. Henry Bunting, “Finding Ourselves in This Antitoxin Problem,” OP 29 (January 1916): 2–3. In 1924 Bunting credited the late Michael A. Lane, a professor at Kirksville with writing this and other editorials on the value of antitoxin under Bunting’s name. The identification of Lane as the author would likely have caused his removal from the faculty. Lane’s claim to fame, which was made prior to his coming into connection with the osteopathic profession, was being the first to identify and name the alpha and beta cells of the Islets of Langerhans, a significant milestone on the way to a greater understanding of the cause and treatment of diabetes. Though an accomplished investigator, Lane’s services as a researcher were rejected by the A. T. Still Research Institute, quite possibly because of his liberal views on serums and vaccines. See Henry Bunting, “Medical Recognition of Professor M. A. Lane’s Contribution to Research,” OP 46 (September 1924): 2–3. See also Robert Nichols, “Editorial: Reasonable Arguments,” Osteopathic Research Internist 1 (December 1924): 163–66.

9. J. Stedman Denslow, “Guest Editorial: Ralph Waldo Gerard, Distinguished and Courageous Scientist,” JAOA 73 (1974): 793–96.

10. J. Stedman Denslow and G. H. Clough, “Reflex Activity in the Spinal Extensors,” journal of Neurophysiology 4 (1941): 430–37; J. Stedman Denslow and C. C. Hassett, “The Central Excitatory State Associated with Postural Abnormalities,” journal of Neurophysiology 5 (1942): 393–402; J. Stedman Denslow and C. C. Hassett, “The Polyphasic Action Currents of the Motor Unit Complex,” American journal of Physiology 139 (1943): 652–59; J. Stedman Denslow, “Analysis of Variability of Spinal Reflex Thresholds,” journal of Neurophysiology 7 (1944): 207–15.

11. J. Stedman Denslow, Irwin Korr, and A. D. Krems, “Quantitative Studies of Chronic Facilitation in Human Motor Neuron Pools,” American journal of Physiology 105 (1947): 229–38. Korr continued his research career into the 1970s. See in particular I. M. Korr, P. N. Wilkinson, and F. W. Chornick,

12. See W. V. Cole, An Introduction to Osteopathic Medicine (Kansas City, Mo.: Kansas City College of Osteopathy and Surgery, 1961), pp. 64–65.

13. Louis Chandler, “Physiological Integration as a Basis for Recovery from Disease and Its Osteopathic Implication,” JAOA 49 (1950): 305–15.

14. For a more detailed summary of pharmocotherapeutic advances during this era, see Ernst Baumler, In Search of the Magic Bullet (London: Thames and Hudson, 1965); L. Earle Amow, Health in a Bottle (PhiladelphiazJ. B. Lippincott, 1970); and John Mann, The Elusive Magic Bullet: The Search for the Peifect Drug (New York: Oxford University Press, 1999).

15. Minutes of the AOA Board of Trustees, July 19–23, 1948, microfilmed, American Osteopathic Archives, Chicago, pp. 72–73.

16. In 1951 the AOA House of Delegates passed a resolution urging the various boards of specialty certification to “insist upon a well developed understanding of osteopathic principles and a demonstrated ability to apply those principles as a primary prerequisite for certification as an osteopathic specialist.” See “Proceedings of the House of Delegates,” JAOA 51 (1951): 25.

17. Lawrence Mills, “Adequacy of Undergraduate Osteopathic Teaching as Judged by Osteopathic Physicians Who Graduated from 1948 through 1953,” microfilmed, American Osteopathic Association Archives, Chicago.

18. Margaret Barnes, “A Fortieth Anniversary Memoir,” The DO 18 (January 1978): 25–29; Margaret Barnes, “History of the Academy of Applied Osteopathy,” The DO12 (June 1972): 113–33.

19. William Garner Sutherland, The Cranial Bowl (USA: Free Press, 1948; reprint of lst ed.).

20. Ibid., p. 67..

21. For the current claims and supporting evidence as put forward by its advocates see Hollis King and Edna Lay, “Osteopathy in the Cranial Field,” Foundations for Osteopathic Medicine, ed. Robert C. Ward (Philadelphia: Lippincott, William s and Wilkins, 2002), pp. 985–1001.

22. Data culled from American Osteopathic Association, Yearbook and Directory (Chicago, 1960).

23. “The Man on the Street Gives His Ideas on Osteopathy,” Forum of Ost 11 (1937): 35, 51–52.

24. George Hartman, “The Relative Social Prestige of Representative Medical Specialties,” journal oprplied Psychology 20 (1936): 659–63.

25. Alice Foley, “Osteopaths or Osteopathic Physicians,” JAOA 25 (1926): 371; M. F. Hulett, “Osteopathic Physician and Surgeon,” JAOA 25 (1926): 458; Cyrus Gaddis, “Away from Congested Centers,” JAOA 26 (1926): 204.

26. “New Medical Dictionary Defines Osteopathy,” Forum of Ost 10 (1936): 205; Ray Hulburt, “Definitions—SpinalJoints—Osteopathic Physicians,” Forum of Oct 5 (1931): 194~95; George McCole, “Osteopathic Definitions,” Forum of Ost 10 (1936): 151, 168.

27. “Proceedings of the House of Delegates,” Forum of Ost 3 (August 1929): 6; “Osteopathic Physicians and Directories,” Forum of Ost 1 (December 1927): 12; R. C. McCaughan, “Report of the Executive Secretary,” 51/10/136 (1937): 594–96.

28. “Federal Emergency Sick Relief,” Forum of Ost 7 (1933): 183——84; “FERA and CW ,” Forum of Ost 7 (1934): 263; “Where Do We Go from Here?” Forum of Ost 12 (1938): 97, 114; B. F. Adams, “Report of the Committee on Compensation Insurance,” JAOA 26 (1946): 93, 94; Robert Homan, “Report of the Committee on Compensation Insurance,” JAOA 48 (1948): 69; John Wood, “The Audrain County Hospital Case,” JAOA 50 (1951): 292–93; Don Cameron, “Can a Hospital Survive a DO Invasion?” Medical Economics 30 (July 1953): 99–105; “Hospital Survey and Construction Act,” JAOA 46 (1946): 24–26; “Important Change in Hospital Construction Act Regulations,” JAOA 46 (1947): 570.

29. Mark Sullivan, “If I Need Relaxation,” Reader’s Digest 34 (February 1939): 86–88.

30. See Jackson Harrison Pollack, Dr. Sam: An American Tragedy (Chicago: Henry Regnery, 1972); and Cynthia Cooper and Sam Reese Sheppard, Mockeiy of justice: The True S tory of the Sheppard Murder Case (Boston: Northeastern University Press, 1995).

31. Raymond Keesecker, “To the Student Wife,” Form of Ost 29 (1955): 322–23. See also Peter K. New, “The Osteopathic Students: A Study in Dilemma,” in Patients, Physicians and Illness, ed. E Gartly Jaco (Glencoe: Free Press, 1958), pp. 413–21.

32. O. W. Barnes, “Fifty Years Forecast of Osteopathy,” Forum of Ost 3 (1929): 119; “Heresy or Science? Should We Award MD Degrees?” Forum of Ost 9 (1935): 29–31, 38.

33. R. McFarlane Tilley, “Report of the Bureau of Professional Education and Colleges,” JAOA 41 (1941): 58, 59.

34. Donald Lewis, “DO and MD,” Forum of Ost 1 (May 1927): 20; Abridged Proceedings, Mid—Year Meeting of the Executive Committee of the Board of Trustees, December 18–20, 1942, microfilmed, American Osteopathic Association Archives, Chicago, pp. 35, 132–33.

35. This failure to identify one’s osteopathic affiliation extended to the hospitals. However, in 1947 the AOA house mandated that all such facilities include either the word osteopathy or the word osteopathic in their title or subtitle. See Floyd Peckham, “Report of the Bureau of Hospitals,” JAOA 47 (1947): 92.

8. The California Merger

1. See Louisa Bartosh, “The History of Osteopathy in California,” Journal of the Osteopathic Physicians and Surgeons of California 5 (April—May 1978): 30–33.

2. “Osteopathic Unit Makes Excellent Showing in Annual Report,” thtern Osteopath 24 (September 1929): 7–10; G. W Woodbury, “The College and Unit #2,” thtern Osteopath 24 (May 1930): 11–14; Louis Chandler, “Progress and Problems at Unit #2,” Western Osteopath 26 (March 1932): 7; L. C. Chandler, “Fishbein vs. the Osteopathic Unit,” Western Osteopath 27 (November 1932): 5–6; Dain Tasker Historical Manuscript, chapters 41–43, Special Collections, University of California-Irvine.

3. W Ballentine Henley, “Comes the Dawn,” JAOA 58 (1958): 141–47.

4. “Proceedings of the House of Delegates,” }AOA 40 (1940): 33–34.

5. Dain Tasker Historical Manuscript, chapter 58.

6. For a discussion of the absorption of the homeopaths and eclectics, see William Rothstein, American Physicians in the Nineteenth Century: From Sects to Science (Baltimore: Johns Hopldns University Press, 1972), pp. 298–326.

7. Arnold Kisch and Arthur Viseltear, Doctors of Medicine and Doctors of Osteopathy in California: Two Medical Professions Face the Problem of Providing Medical Care (Arlington, Va.: Department of Health, Education and Welfare, Public Health Service, Division of Medical Care Administration, 1967), pp. 14–15.

8. Minutes of the California Osteopathic Association House of Delegates and Board of Trustees, March 18–19, 1944, microfilmed, American Osteopathic Association Archives, Chicago, pp. 5–6.

9. Ibid., p. 7; Kisch and Viseltear, Doctors of Medicine, p. 15.

10. Minutes of the California Osteopathic Association House of Delegates and Board of Trustees, March 18–19, 1944, p. 7; Minutes of the California Osteopathic Association, Report of the Fact-Finding Committee, March 3–4, 1945, microfilmed, American Osteopathic Association Archives, Chicago.

11. Metropolitan University, College of Medicine and Surgery, Graduate Division, Annual Catalog (Los Angeles, 1945); Metropolitan University File, microfilmed, American Osteopathic Association Archives, Chicago.

12. Minutes of the American Osteopathic Association Board of Trustees, July 1946, microfilmed, American Osteopathic Association Archives, Chicago, pp.171–75.

13. A detailed file of meetings, reports and letters related to the discussions between representatives of the COA and the CMA can be found in the Forest Grunigen Papers, Special Collections, University of California-Irvine. See also Dolores Grunigen and Jay O’Connell, A Strength Born of Giants: The Life and Times of Dr. Forest Grunigen (Van Nuys, Calif.: Raven River Press, 2002), pp. 51–95.

14. Grunigen and O’Connell, A Strength Born of Giants, 51–95.

15. Minutes of the American Osteopathic Association Board of Trustees, July 11–15, 1949, microfilmed, American Osteopathic Association Archives, Chicago, pp. 201–2; Minutes of the California Osteopathic Association House of Delegates and Board of Trustees, April 27–28, 1949, microfilmed, American Osteopathic Association Archives, Chicago, p. 15.

16. Facts Relating to the Origins of the AOA-AMA Conference Committee Meetings, n.d., microfilmed, American Osteopathic Association Archives, Chicago, p. 4.

17. Kisch and Viseltear, Doctors of Medicine, pp. 15 ~16.

18. Ibid., pp. 5–6.

19. “Editorial: The AOA and AMA Conferences,” Forum of Ost 27 (1953): 186–87.

20. Wire Recording Notes Taken March 8, 1952 , by the American Osteopathic Association Conference Committee, microfilmed, American Osteopathic Association Archives, Chicago.

21. “Editorial: The AOA and AMA Conferences,” p. 187.

22. Ibid.

23. “Address ofthe President, Dr. John W Cline,” JAMA 149 (1952): 853–56; “Report of the Reference Committee on Miscellaneous Business,” JAMA 149 (1952): 944; “Report of Officers,” JAMA 150 (1952): 892; “Report of the Judicial Council,” JAMA 150 (1952): 1706.

24. “Editorial: The AOA and the AMA Conferences,” p. 188.

25. “Report of the Committee for the Study of Relations between Osteopathy and Medicine,” JAMA 152 (1953): 734–39.

26. Report of the American Osteopathic Association Conference Committee to the A.O.A. House of Delegates, July 1954, microfilmed, American Osteopathic Association Archives, Chicago, p. 2.

27. Ibid., pp. 2–7.

28. Ibid., pp. 11–17.

29. Ibid., pp. 17–19.

30. Minutes of the American Osteopathic Association House of Delegates,July 1954, microfilmed, American Osteopathic Association Archives, Chicago, 281.

31. “Supplementary Report of the Board of Trustees,” JAMA 156 (1954): 1600-1605; “The AOA and AMA Conferences: To Settle with Finality,” Forum of Ost 28 (1954): 611–14.

32. Report of the Committee for the Study of Relations between Osteopathy and Medicine," JAMA 158 (1955): 736–42.

33. Ibid., p. 740.

34. Ibid., p. 741.

35. Ibid., pp. 41–42.

36. Minutes of the Meeting of the American Osteopathic Association Conference Committee, June 11, 1955, microfilmed, American Osteopathic Association Archives, Chicago, pp. 1–5.

37. “The AOA and AMA Conferences: Settled without Finality,” Forum of Ost 29 (1955): 244–47.

38. True B. Eveleth to Floyd Peckham, November 21, 1957, microfilmed, American Osteopathic Association Archives, Chicago.

39. “Proceedings of the House of Delegates,” JAOA 57 (1957): 68.

40. Ibid.

41. “Highlights of the Atlantic City Meeting,” JAMA 168 (1958): 2150.

42. “Report of the Judicial Council,” JAMA 171 (1959): 978–79.

43. “Highlights of the Atlantic City Meeting,” JAMA 170 (1959): 1075; “MDs Can Teach DOs—If,” American Osteopathic Association News Bulletin (hereafter AOA News Bull) (June 1959): 1–2.

44. “Remarks of George W. Northup, DO, to the House of Delegates, July 12, 1959,” microfilmed, American Osteopathic Association Archives, Chicago, pp. 1–5.

45. “Text of Michigan Resolution,” A CA News Bull 3 (August 1959): 1.

46. Forest Grunigen Papers; Kisch and Viseltear, Doctors of Medicine, pp. 23–24.

47. Ibid., pp. 25–27; “AOA Acts on Unity Talks,” AOA News Bull 3 (August 1960): l.

48. “Text of Michigan Resolution,” p. 3.

49. Kisch and Viseltear, Doctors of Medicine, p. 28; “COA Charter Revoked,” AOA News Bull 3 (November 1960): 1.

50. “AOA Charters New Group,” AOA News Bull 4 (February 1961): 1.

51. Kisch and Viseltear, Doctors of Medicine, p. 31.

52. “A Report to the Membership,” JAOA 60 (1961): 671–74.

53. Kisch and Viseltear, Doctors of Medicine, pp. 34–36.

54. Ibid., pp. 33–34.

55. “California Merger Program: Important Dates,” microfilmed, American Osteopathic Association Archives, Chicago.

9. Reaffirmation and Expansion

1. “Osteopathy: Special Report of the Judicial Council to the AMA House of Delegates,” fAlVIA 177 (1961): 775.

2. “Editorial: Osteopaths vs. Osteopathy,” j’AlVIA 177 (1961): 779.

3. “Osteopathy: Special Report of the Judicial Council,” p. 775.

4. “Trustees Statement on AMA Policy,” A CA News Bull 4 (July 1961): 3.

5. Ibid. Following this line of reasoning, economist Erwin Blackstone argued that the principal motivation behind this and other AMA policies towards theDOs was a desire to eliminate a viable competitor. See his “The AMA and the Osteopaths: A Study of the Power of Organized Medicine,” The Antitrust Bulletin 22 (1977): 405–40. See also Howard Wolinsky and Tom Brune, The Serpent on the Staff? The Unhealthy Politics of the American Medical Association (New York: G. P. Putnam’s Sons, 1994) pp. 121–43.

6. “Medical Societies Confer with Osteopaths,” AMA News 8 (March 1, 1965): 2.

7. “Washington State MD-DO Plan Told,” AMA News 6 (November 11, 1963): 16; “MD-DO Merger Efforts Continue,” AMA News 7 (April 13, 1964): 16; “MD Degrees for Osteopaths Validated,” AMA News 10 (January 9, 1967): 9; “Osteopaths’ MD Degrees Denied,” AMA News 11 (January 8, 1968): 1, 11.

8. “DOs Attend Town Hall Meeting to Discuss Current AOA Policies,” A CA News Bull 5 (May 1962): 1; “AOA VVlll Hold Town Hall Session at MAOP&S Meeting,” AOA News Bull 5 (October 1962): l.

9. Galen Young, “Message from the President of the AOA,” JAOA 59 (1960): 487–88.

10. Arnold Kisch and Arthur Viseltear, Doctors of Medicine and Doctors of Osteopathy in California: Two Medical Professions Face the Problem of Providing Medical Care (Arlington, Va.: Department of Health, Education, and Welfare, Public Health Service, Division of Medical Care Administration, 1967), p. 40; “When DOs Become MDs,” Medical Economics 40 (December 2, 1963): 62.

11. See Nancy Kaye, “DOs Turned MDs: How Are They Faring?” Medical Economics 40 (November 4, 1963): 115–25.

12. Kisch and Viseltear, Doctors of Medicine, p. 42.

13. Ibid., p. 41.

14. “Profile of a Merger: Responses to Questionnaires, Analyses, Comments Conducted November 17–20, 1965, in California by the A.O.A. Public Relations Department,” microfilmed, American Osteopathic Association Archives, Chicago.

15. Ibid., p. 6.

16. For an internal biography ofthe new school by an early MD dean, as well as his history of COP&S see Warren Bostick, College of Medicine, University of California-Irvine (Irvine: n.p., 1994).

17. “Sues to Stop Recognition of Little md by New York,” AOA News Bull 9 (February 1966): 5. In New York, however, as a result of an administrative decision by the State Department of Education, DOs who held 1961 California College of Medicine diplomas could, if they chose, be listed on their license as “DO-MD,” though they were examined and licensed on the basis of their osteopathic credentials. Although this practice was stopped by the courts in 1968, fifteen DOs won the right to retain this designation. “Fifteen New ‘DO-MDs’ Result from New York’s Ruling,” AMA News 7 (February 17, 1964): 16; “Certificate Listing ‘MD-DO’ Prompts New York Lawsuit,” AMA News 9 (February 28, 1966): 9; “Osteopaths’ MD Degrees Denied,” AMA News 11 (January 8, 1968): l, 11; “Osteopaths Can Display ’MD,”’ AMA News 13 (February 2, 1970): 14.

18. See Kaye, “DOs Turned MDs: How Are They Faring?”

19. Jack Leahy, “How DOs Feel about AOA-AMA Relations,” OP 38 (July 1972): 28.

20. “AHA Changes Listing Criteria,” AOA News Bull 3 (October 1960): 1.

21. “Joint Commission Okays Mixed Staffs,” AOA News Bull 3 (October 1960): 1.

22. “Changes in DO Policy Opposed,” AMA News 8 (May 3, 1965): 7; “Medicolegal Decisions,” AMA News 11 (November 25, 1968): 13; “Oppressive Actions in Maryland, Nebraska Seek to Deny Full Licensing of DOs,” AOA News Bull 8 (May 1965): 3.

23. “DOs Qualifyfor Positions with US. Civil Service,” AOA News Bull 6 (May 1963): 2; “Order Armed Forces to Commission DOs as Medical Officers,” AOA News Bull 9 (June 1966): 1; “US. Recognizes AOA Hospital Accreditation for Use in Medicare,” AOA News Bull 9 (November 1966): 1, 8. See also Norman Gevitz, “The Sword and the Scalpel: The Osteopathic War to Enter the Military Medical Corps,” JAOA 98 (1998): 279–86.

24. “DO Education Changes Urged,” AMA News 10 (July 3, 1967): 1, 8. See also “House of Delegates Meets,” JAMA 201 (1967): 38.

25. “House of Delegates Rebuffs ‘Acadernic Piracy’ of AMA,” AOA News Bull 10 (August 1967): 1, 8.

26. See Carl Waterbury, “DO-MD: Some Guidelines,” OP 35 (November 1969): 17–19. J. Dudley Chapman, “The Other Side of the Des Moines College Crisis,” OP 36 (July 1970): 17–23; “Dr. Waterbury Speaks Out on COMS,” OP 37 (May 1971): 21–23.

27. “AMA Offers Means for DO Membership,” AMA News 11 (December 16, 1968): 1, 8.

28. “DOs Can Now Join the AMA,” AMA News 12 (July 28, 1969): 6; “Eligibility of Osteopaths for County and State Medical Society Membership,” JAMA 210 (1969): 1512.

29. “House of Delegates Takes Action to Resolve Conflict of Interest,” A OA News Bull 11 (August 1968): 1; “AOA House of Delegates Reaffirms Separate Status for DOs,” American Osteopathic Association News Review 12 (September 1969): 1–2.

30. Edward Crowell, “AOA House and Board Meet in Denver: Reaffirm Membership Policy, Approve Health Insurance Statement,” The DO 12 (October 1971): 45–46, 56–58; idem, “AOA Board and House Meet: Take Significant Actions,” The DO 14 (October 1973): 75476.

31. Data furnished by the American Medical Association, Department of Membership, December 1978.

32. “AOA House of Delegates Reaffirms Separate Status,” pp. 1–2.

33. Carolyn Cranford, “AOA-AAOC Meet in Chicago,” The DO 10 (February 1970): 51.

34. Barbara Peterson, “AOA House of Delegates Moves to Serve the Public Health,” The DO 11 (September 1970): 53.

35. “Editorials,” JAOA 70 (1970): 104.

36. Final Report of the Osteopathic Medical Manpower Information Project (Washington, D.C.: American Association of Colleges of Osteopathic Medicine, 1977) p. 40; “Medical Education in the United States,” JAMA 218 (1971): 1247–48; 222 (1972): 1011–12; 226 (1973): 945; 238 (1977): 2790–92; 240 (1978): 2842–44. In the year 1972 to 1973 there were 415 DOs in AOA-accredited hospital residencies. In the year 1976 to 1977 the figure was 531. See Final Report of the Osteopathic Medical Manpower Information Project, p. 41.

37. “Osteopathy Ruling Voided,” American Medical News 16 (October 15, 1973): 1, 3.

38. Rosemary Stevens, American Medicine and the Public Interest (New Haven: Yale University Press, 1971), pp. 362–67; William Rothstein, American Medical Schools and the Practice of Medicine (New York: Oxford University Press, 1987), pp. 283–88; Kenneth Ludmerer, Time to Heal: American Medical Education from the Turn of the Century to the Era of Managed Care (New York: Basic Books, 1999), pp.210–15.

39. Data culled from US. Department of Health, Education, and Welfare, Public Health Service, Health Resources Administration, Health Professions Schools: Selected BHM Support Data F K 1965–1976 (Washington, D.C.: US. Department of Health, Education, and Welfare, 1977), p. 120.

40. Institute of Medicine, Costs of Education in the Health Professions (Bethesda, Md.: National Academy of Sciences, US. Department of Health, Education, and Welfare, Public Health Service, Health Resources Administration, Bureau of Health Resources Development, 1974), pp. xiv, xviii.

41. Data culled from catalogs of the colleges for the respective years.

42. Final Report of the Osteopathic Medical ManpowerInformation Project, pp. 47–54.

43. “Michigan Plans New College,” A 0A News Bull 6 (May 1963): 1; “Michigan College Site Moved from Lansing to Pontiac,” A 0A News Bull 7 (December 1964): 1.

44. “Michigan College Moves Two Steps,” A 0A News Bull 8 (August 1965): 3; “Michigan Study Cites Role of DOs,” AOA News Bull 4 (August 1961): 3; “Plan for Health Care Drafted in Michigan,” A 0A News Bull 5 (September 1962): 4.

45. “Michigan College Moves Two Steps,” p. 3.

46. “Michigan DOs Vote 87 Percent against Merger,” AOA News Bull 9 (April 1969): 1–2.

47. “Michigan to Establish Osteopathic School,” AOA News Review 12 (August 1969): 1–2.

48. Ibid., p. 2; see also John Walsh, “Medicine at Michigan State,” Science 177 (1972): 1085–87; Science 178 (1972): 36–39, 288–91, 377–80.

49. “TCOM Becomes State—Supported Medical School as Governor Briscoe Signs SB. 216,” Runs Osteopathic Physiciansfournal 32 (July 1975): 12–13; “Basic Science Education Agreement Signed with State University,” The DO 12 (April 1972): 171; “TCOM Receives Government Funding in Excess of $800,000,” The DO 13 (October 1972): 201–2; “State Grants $3.4 Million Appropriation for TCOM,” The DO 13 (August 1973): 202.

50. Robert Osborne, A History of the Oklahoma State University College of Osteopathic Medicine (Stjllwater, Okla.: Oklahoma State University, 1998), pp. 29–123.

51. Carol Thiessen, “Greenbriar: The Little College that Could,” The DO 15 (March 1975): 86–92; Penny Ellis and Alayne Steiger, The DOs: Medicine in the Mountains (Charleston: West Virginia Society of Osteopathic Medicine, 1986) pp. 100–108.

52. Carol Thiessen, “And Now There Are Ten,” The DO 17 (September 1976): 85.

53. Jeff Kressman, “New Colleges Open in New Jersey, New York,” The DO 18 (March 1978): 33–37.

54. Edward Crowell, “Accelerating Educational Growth Dominates Board Session,” The DO 19 (October 1978): 61.

55. Carol Thiessen, “California Supreme Court Reopens the Golden State to Licensure,” The DO 18 (April 1978): 46.

56. Allen Singer, 2000 Annual Statistical Report (Bethesda, Md.: American Association of Colleges of Osteopathic Medicine, 2001) p. 13; US. Department of Health, Education, and Welfare, Public Health Service, Health Resources Administration, Office of Graduate Medical Education, Interim Report of the Graduate Medical Education National Advisory Committee to the Secreta1y(Hyattsville, Md.: Department of Health, Education, and Welfare, 1979), p. 161.

10. In a Sea of Change

1. General works on the origins of and early developments in Medicare and Medicaid include Rashi Fein, Medicare, Medical Costs: The Search for a Health Insurance Policy (Cambridge: Harvard University Press, 1986); Theodore Marmor, The Politics of Medicare (London: Routledge and Kegan Paul, 1970); Sheri David, With Dignity: The Search for Medicare and Medicaid (Westport, Conn.: Greenwood Press, 1985); Robert Stevens and Rosemary Stevens leare in America: A Case Study of Medicaid (New York: Free Press, 1974).

2. For the method of calculating Medicare reimbursement of the costs of osteopathic internships and residencies see James Carl and Ronald Knaus, “A Primer on Graduate Medical Education Financing,” JAOA 93 (1993): 1055–59.

3. See Odin Anderson, Blue Cross Since 1929: Accountability and the Public Trust (Cambridge, Mass.: Ballinger, 1975); Sylvia Law, Blue Cross: l/Vbat Went Wrong? 2nd ed. (New Haven: Yale University Press, 1976); Robert Cunningham III and Robert Cunningham Jr., The Blues: A History of the Blue Cross and Blue Shield System (DeKalb: Northern Illinois University Press, 1997).

4. Alain Enthoven “A New Proposal to Reform the Tax Treatment of Health Insurance,” Health Afiairs 3(1984): 21–39.

5. Paul Starr, The Social Transformation of American Medicine (New York: Basic Books, 1982), p. 394.

6. Harry Sultz and Kristina Young, Health Care USA: Understanding Its Organization and Delivezy, 3rd ed. (Gaithersburg, Md.: Aspen Publications, 2001), p. 230.

7. Rosemary Stevens, In Sickness and in WE’alt/J: American Hospitals in the Twentieth Century (New York: Basic Books, 1989) pp. 307–9.

8. In 1970 the AOA House of Delegates unanimously supported the concept of comprehensive national health insurance. See The DO 11 (September 1970): 47–49. However, by 1979, experience with federal reimbursement policies and mandates was instrumental in the AOA’s rescinding of its support. “National Health Policy Statement,” The DO 20 (October 1979): 31–32.

9. Edward Crowell, “AOA Board and House Meet,” The DO 14 (October 1973): 73; Wallace Pearson, “Council on Federal Health Programs,” The DO 15 (October 1974): 163–64; Frank McDevitt, “Study Committee on HMOs, PSROs and Physicians’ Unions,” The DO 16 (October 1975): 117–18.

10. Donald Siehl, “Medical Care Criteria,” The DO 17 (November 1976): 67–69.

11. John Perrin, “Washington Office,” The DO 19 (November 1978): 131.

12. George Luibel, “Department of Public Affairs,” The DO 15 (October 1974): 151–52; Edward Crowell, “Osteopathic Education Dominates Cincinnati Meeting,” The DO 19 (October 1978): 64; “Plans Turned Down; DOMC Tries Again,” The DO 19 (May 1978): 75, 77; “Community Champions Hospital Against Planning Agency,” The DO 22 (June 1981): 85–87.

13. John Perrin, “Washington Office,” The DO 21 (October 1980): 117.

14. John Perrin, “Washington Office,” The DO 23 (October 1982): 150; Frank McDevitt, “Department of Government Affairs,” The DO 24 (October 1983): 162; “New Osteopathic Hospital Opens in Florida,” The DO 32 (February 1991): 106.

15. Sultz and Young, Health Care USA, p. 216.

16. Marcelino Oliva, “Bureau of Public Education on Health,” The DO 25 (October 1984): 154; Elmer Baum, “Council on Federal Health Programs,” The DO 25 (October 1984): 156; Rich Wolter, “Changes in PROS Designed to Better Relations with Physicians,” The DO 32 (September 1991): 81–87.

17. Kenneth Thorpe and James Knickman, “Financing fOr Health Care,” in Health Care Delivery in the United States, ed. Anthony Kovner and Steven Jonas (New York: Springer Publishing, 1999), pp. 54–56.

18. Sultz and Young, Health Care USA, pp. 110–35.

19. Lawrence Brown, Politics and Health Care Organization: HMOs as Federal Policy (Washington, D.C.: Brookings Institution, 1983); John B. McKinley, ed. Health Maintenance Organizations (Cambridge: MIT Press, 1981).

20. James Robinson, The Corporate Practice of Medicine (Berkeley: University of California Press, 1999).

21. Janet Horan, “National Study of the Impact of Managed Care on Osteopathic Physicians,” JAOA 100 (2000): 218–27. See also Barbara Ross—Lee and Michael Weiser, “Managed Care: An Opportunity for Osteopathic Physicians,” JAOA 94 (1994): 149-56; Daniel Bade, “AOA Mounts Response to Managed Care Industry,” The DO 35 (February 1994): 57–60.

22. Michael Fitzgerald, “AOA Evaluates Values Assigned to OMT Codes,” The DO 32 (April 1991): 76, 79. Daniel Bade, “Reimbursement for OMT Improves Under New MFS,” The DO 33 (September 1992): 91–92.

23. Jennifer Cook and John Sprovieri, “Dr. Stowers Becomes First DO to Serve on PPRC,” The DO 36 (May 1995): 29–30. In 2000 this DO became the first osteopathic physician to be appointed to MedPAC, the successor of the PPRC. See Heidi Ann Ecker, “Dr. Stowers Joins MedPAC as its First DO Member,” The DO 41 (June 2000): 63–65.

24. Stacy Bohlen, “Battle to Correct OBRA Omission Continues,” The DO 35 (December 1994): 28–40; idem, “Congress Corrects OBRA ’90 Oversight,” The DO 37 (November 1996): 48–53.

25. R. W. Hubbard, “Bureau of Public Education on Health,” The DO 31 (October 1990): 31; Elizabeth Beckwith, “Department of Government Relations,” The DO 34 (October 1993): 110–11; Anthony Minissale, “Bureau of State Government Affairs,” The DO 36 (October 1995): 96.

26. In addition, although HCFA issued a policy declaring that DOs could be reimbursed for both evaluation and management (EM) and OMT performed during the same visit, little implementation occurred at the Medicare carrier level. See “AOA Moves to Address OMT Reimbursement Problems,” The DO 34 (April 1993): 33; John Sprovieri, “AOA Prompts HCFA to Issue Statement on OMT Codes,” The DO 35 (November 1994): 80–82; Jennifer Berger, “Get What You Deserve: Perseverance, Saavy Key to Obtaining Reimbursement for OMT,” The DO 39 (May 1998): 62–70; Amy Bennett, “Cac0phony of Coding Can Be Cleared Up,” The DO 42 (January 2001): 64–66.

27. “AOHA Releases Cost Data,” The DO 18 (August 1978): 75; “Hospitals Growing—and So Are Costs,” The DO 21 (March 1981): 121.

28. George Northup, “The Osteopathic Hospital,” JAOA 80 (1980): 14–15, 96–97, 172–73, 244, 322; Bruce Krider, “Integrated Hospital Staffs: Will [They] Lead to DO—MD Amalgamation,” OP 45 (August 1978): 43–45; Gilbert Toffol, “Saving DO Hospitals,” The DO 30 (January 1989): 19.

29. “Osteopathic Organizations Seek Answers to Utilization Issue,” The DO 25 (October 1984): 97; “DOs and DO Hospitals: A Loyalty Issue,” The DO 27 (January 1986): 131–32.

30. “OP News Notes,” OP 45 (August 1978): 6; “Osteopathic Hospitals Expand,” The DO 22 (August 1982): 160–61.

31. Anne—Marie Roussel, “DRGs and Teaching Hospitals—An Uncertain Alliance,” The DO 25 (November 1984): 105–6; “Hospital Sues Blue Cross for False Advertising,” The DO 26 (February 1985): 13; John Sprovieri, “Hospitals Challenge Tough Economic Climate,” The DO 29 (March 1988): 118–20; John Sprovieri, “Quality, Not DRGs, Should Guide Hospital Payment,” The DO 30 (February 1989): 123–24.

32. Roger Zumwalt, “DRGs—Survival Strategies for Small Osteopathic Hospitals,” The DO 25 (November 1984): 111–12; “Merge or Submerge?” The DO 26 (November 1985): 145–48; “Metropolitan Hospital Sells Its Divisions,” The DO 31 (June 1990): 11; Richard Sims, “Osteopathic Hospitals Have Critical Choices to Make in the 1990s,” The DO 32 (April 1991): 16–29; “Financial Woes Spur Detroit Osteopathic Hospital to Merge with Detroit Riverside,” The DO 34 (February 1993): 123–24; “Columbia/HCA Acquires Chicago Osteopathic Hospitals,” The DO 37 (April 1996): 66; Lydia Hodges, “Medical Mecca Remembered,” The DO 40 (June 1999): 34–37; Carol Benenson Perloff, To Secure Merit: A Century of Philadelphia College of Osteopathic Medicine, 1899–1999 (Philadelphia: Philadelphia College of Osteopathic Medicine, 1999) pp. 64–67.

33. Data derived from AOA Yearbook and Directoiy of Osteopathic Physicians 1974 (Chicago: American Osteopathic Association, 1974), pp. 45–58; AOA lizarbook and Directory of Osteopathic Physicians 1988–1989 (Chicago: American Osteopathic Association, 1989), pp. 595–604; AOA lizarbook and Directory of Osteopathic Physicians 1999 (Chicago: American Osteopathic Association, 1999), pp. 730–35.

34. Mike Fitzgerald, “Specialty Hospitals: For Some an Alternative to Closing,” The DO 29 (March 1988): 121–26; Ruth Mack, “Confronting Competition with Innovative Services,” The DO 29 (March 1988): 127–29.

35. “Foundations Offer Future to Failing Hospitals,” The DO 30 (May 1989): 116–21; David Rianda, “National Association of Osteopathic Foundations,” The DO 32 (October 1991): 131–32; Carol Williams, “Foundations Play Critical Role in Promoting Profession,” The DO 34 (November 1993): 82–86.

36. John Sprovieri, “Osteopathic Hospitals Strive to Maintain Identity in Changing Environment” The DO 36 (June 1995): 58–59; George Reuther, “Passing Muster: HFAP’s AOA Program Ensures Quality of Healthcare Facilities,” The DO 40 (June 1999): 20–26; “AOA First to Earn Authority to Accredit Critical Access Hospitals,” The DO 43 (February 2002): 73.

37. A 0A Yearbook and Directory 1974, pp. 45–58; AOA Yearbook and Directory 1999, pp. 730–35. Unfortunately these totals for recorded beds include hospitals that appear to be counting “licensed” beds as well as those institutions who limit their bed totals to actual beds currently in service. In 2002, the American Osteopathic Health Care Association (AOHA), which represented member osteopathic hospitals in Washington for decades, ceased operations and its functions were taken over by the American Osteopathic Association.

38. Leonard Fenninger and Rose Tracy, “Graduate Medical Education,” in Medical Education in the United States, 1973–74, ed. Anne Crowley (Chicago: American Medical Association, 1975), p. 35.

39. “Hospital Requirements for Intern Training and the Intern Registration Program,” JAOA 76 (April 1977) supplement: 119–25.

40. Edward Crowell, “AOA Board and House Approve Special Assessment,” The DO 18 (October 1975): 55 -61; idem, “Board, House Respond to Small States’ Concerns,” The DO 18 (October 1977): 37–39.

41. “Task Force on Graduate Osteopathic Medical Education,” The DO 21 (April 1981) supplement: 72–74.

42. Frank Campion, The AMA and US. Health Policy (Chicago: Chicago Review Press, 1984), pp. 447-52.

43. Mark Cummings, “Challenge to Osteopathic Education: Returning to its Primary Care Roots,” j’AA/IA 268 (1992): 1139–40; idem, “Combined Allopathic and Osteopathic GME Programs: A Good Thing, But Will They Continue?” Academic Medicine 74 (1999): 948–50.

44. Mark Cummings and Jan Wachtler, “Trends in Postdoctoral Training,” JAOA 85 (1985): 722; Carolyn Swallow, Verna Bronersky, and Pamela Falbo, “Osteopathic Graduate Medical Education,” JAOA 97 (1997): 647.

45. Michael Opipari, “Specialty-Oriented Internships,” JAOA 94 (1994): 509–11; Helen Baker and Janice Wachtler, “Osteopathic Postdoctoral Education,” JAOA 90 (1990): 1010–13; Swallow, Bronersky, and Falbo, “Osteopathic Graduate Medical Education,” p. 647.

46. “Report of the Task Force to Explore Alternate Approval Mechanisms for Postdoctoral Training,” The DO 29 (September 1988): 97-100; Swallow, Bronersky, and Falbo, “Osteopathic Graduate Medical Education,” p. 657; Cummings and Wachtler, “Trends in Postdoctoral Training,” p. 723.

47. In 1985–86, 12 percent of graduating DOs entered programs accredited by ACGME. In 1995 —-96, it was 23 percent. Unfortunately, it is not known how many of these ACGME programs were also accredited by the AOA. Baker and Wachtler, “Osteopathic Postdoctoral Education,” pp. 1010-13; Carolyn Swallow, “Osteopathic Graduate Medical Education,” JAOA 100 (2000): 682.

48. Swallow, Bronersky, and Falbo, “Osteopathic Graduate Medical Education,” p. 657. See Andrew Pecora, “Factors Influencing Osteopathic Physicians’ Decisions to Enroll in Allopathic Residency Programs,” JAOA 90 (1990): 527–33. In 1988 the AOA changed its rules governing approval of nonfederal ACGME residency training. Until then, the AOA would not approve an ACGME residency taken by a DO after an AOA approved internship when there were available open positions in the same specialty within osteopathic programs. Graduates needed first to apply to currently active and funded osteopathic residencies. After 1988, DOs completing an AOA rotating internship could directly apply to the AOA Committee on Postdoctoral Training for approval to take an ACGME residency. See “More Grads May Prompt Revised Residency Rules,” The DO 29 (August 1988): 114–15.

49. Swallow, Bronersky, and Falbo, “Osteopathic Graduate Medical Education,” pp. 646–47.

50. Michael Fitzgerald, “AOA Adopts Alternate Pathway for Board Certification,” The DO 40 (June 1999): 18–19; “AOA Board Approves Alternatives for Obtaining AOA Approval of Internships,” The DO 43 (March 2002): 8.

51. Christopher Meyer, “The Osteopathic Medical Game: New Strategies for VVlnning,” JAOA 94 (1994): 715–31.

52. Christopher Meyer, “COGMET Offers Model for Osteopathic Consortia,” The DO 32 (December 1991): 71–75.

53. Christopher Meyer, Ronald Portanova, Cheryl Riley, et al. “The Anatomy of an OPTI: Part 2. The CORE system,” JAOA 97 (1997): 686-91.

54. Michael Opipari, “Osteopathic Postdoctoral Training Institution: The Osteopathic ‘Road Map’ to Graduate Medical Education Viability,” JAOA 95 (1995): 666–67; Christopher Meyer, Mary Patt Mann, Cheryl Riley, et al. “Anatomy of an OPTI: Part 1. Form, Function, and Relationships,” JAOA 97 (1997): 599–603; Bruce Bates, “OPTIs Pose Problems for Small States, Small Hospitals,” The DO 36 (December 1995): 57–60; Dennis Agostino, “New College Limits Difficulties in Creating an OPTI,” The DO 39 (December 1998): 63–66.

55. John Crosby, “Who Moved My Cheese? Optimizing OPTIs in the Post-BBA ’97 Era,” The DO 42 (August2001): l l—13;Jed Magen, “Current Threats to Osteopathic Graduate Medical Education,” JAOA 102 (2002): 156–60.

56. Oliver Hayes, “Dual Approval of a Residency Program: Ten Years Experience and Implications for Postdoctoral Training,” JAOA 98 (1998): 647–52;Jill Svoboda, “As DO Graduates Multiply, AOA Pushes for New GME Sites,” The DO 42 (February 2001): 58–61.

11. The Challenge of Distinctiveness

1. John Crosby, “‘News’ for 2000: New Hope, New Projects, New Opportunities,” The DO 41 (January 2000): 19–20; Howard Levine, “Our Last Frontier,” The DO 42 (September 2001): 56; “AOA Fact Sheet,” The DO 41 (August 2000): 26–29; Donald Cherry and David Woodwell, “National Ambulatory Medical Care Survey: 2000 Summary,” Advance Data, June 5, 2002, No. 328. (Washington, D.C.: National Center for Health Statistics), p. 3.

2. Jacquie Goetz, “Emerging States Fight to Make Name for Themselves,” The DO 41 (November 2000): 43–47; “AOA Fact Sheet,” pp. 28–29.

3. Allen M. Singer, 2001 Annual Report on Osteopathic Medical Education (Chevy Chase, Md.: American Association of Colleges of Osteopathic Medicine, 2002), p. 22. “Osteopathic Medical College Established in Arizona,” The DO 37 (April 1996): 16; “New Osteopathic School Opens,” The DO 34 (July 1993): 9; James Castro, “A Medical School for the Mountains: Training Doctors for Rural Care,” Appalachia 34 (September—December 2001): 24–29.

4. For the profession’s response to the GMENAC report, which was the first of many studies calling for a cap on new and expanded medical schools, see George Northup, “Too Many or Too Few,” JAOA 80 (1981): 387–88. For the location of DO graduates see Gary Gugelchuk and Judy Cody, “Physicians in Service to the Underserved: An Analysis of the Practice Locations of Alumni of Western University of Health Sciences College of Osteopathic Medicine of the Pacific, 1982–1995,” Academic Medicine 74 (1999): 557–59; Allan Roberts et al., “An Approach to Training and Retaining Primary Care Physicians in Rural Appalachia,” Academic Medicine 68 (1993): 122–25; R. Tennyson William s, “Twenty Year Trends in the Ohio Generalist Physician Workforce,” journal of Family Practice 47 (1998): 434–39. See also E. S. Salsberg and G. J. Forte, “Trends in the Physician Workforce, 1980–2000,” Health Aflairs 21 (2002): 165–73.

5. “AOA Fact Sheet,” p. 28; “The Third Annual Primary Care Scorecard,” The New Physician 47 (April 1998): 13–15. Douglas Wood and Barbara Ross-Lee, “The Medical School Curriculum for the 21st Century,” JAOA 98 (1998): 102–11.

6. For the 1999–2000 academic year there were an average of 69 full-time faculty members at DO schools compared to an average of 791 full-time faculty at MD schools. Unlike MD colleges, osteopathic institutions are heavily dependent upon part-time and voluntary clinical faculty to deliver their curricula. See Singer, 2001 Annual Report on Osteopathic Medical Education, p. 50; and Le’Etta Robinson, AAM C Data Boole (Washington, D.C.: American Association of Medical Colleges, 2000), p. 33.

7. John Lynch, “Clinical Research and the Osteopathic Profession,” unpublished paper presented at the AOA Council on Federal Health Programs, September 2000, Washington, DC. See also Norman Gevitz, “Researched and Demonstrated: Inquiry and Infrastructure at Osteopathic Institutions,” JAOA 101 (2001): 174–78. In fiscal year 2000, data on the distribution of expenditures by function in osteopathic schools reveals that publicly financed osteopathic colleges devoted 7.4 percent of their expenditures to research compared to 1.4 percent by the private schools. See Singer, 2001 Annual Report, p. 58.

8. Singer, 2001 Annual Report, pp. 54–57. For an examination of recent challenges to allopathic medical education as a consequence of managed care see Kenneth Ludmerer, Time to Heal (New York: Oxford University Press, 1999).

9. Unpublished data furnished by the American Association of Colleges of Osteopathic Medicine, Chevy Chase, Md.

10. See for example “Chicago Osteopathic Health Systems Creates University,” The DO 34 (June 1993): 30; “Nova Southeastern University Breaks Ground for Health Professions Complex,” The DO 36 (March 1995): 78; “KCOM Builds Phoenix Training Facility,” The DO 36 (January 1995): 10; “University in Des Moines Adopts New Name,” The DO 40 (November 1999): 62.

11. The most serious threats of closure occurred in the freestanding publicly funded osteopathic schools in Oklahoma and West Virginia. See Robert E. Osborne, A History of the Oklahoma State University College of Osteopathic Medicine (Stillwater: Oklahoma State University, 1998), pp. 165–200; Penny Ellis and Alayne Steiger, The DOs: Osteopathic Medicine in the Mountains (Charleston: West Virginia Society of Osteopathic Medicine, 1986), pp. 131–34; “Dr. Oliva Urges West Virginia to Continue School’s State Funding,” The DO 30 (April 1989): 13; “West Virginia Votes to Continue Sponsoring Osteopathic School,” The DO 30 (May 1989): 13; “West Virginia School of Osteopathic Medicine Survives Merger Threat,” The DO 32 (October 1991): 122.

12. Singer, 2001 Annual Report, pp. 22–28. See also Douglas Eckberg, “The Dilemma of Osteopathic Physicians and the Rationalization of Medical Practice,” Social Science and Medicine 25 (1987): 1111–20; Vladimir Shlapentokh, Neil O’Donnell, and Mary Beth Grey, “Osteopathic Interns’ Attitudes Toward Their Education and Training,” JAOA 91 (1991): 786–802; Margaret Aguwa and Daniel Liechty, “Professional Identification and Affiliation of the 1992 Graduate Class of the Colleges of Osteopathic Medicine,” JAOA 99 (1999): 408–20.

13. Larry Besaw, “MDs and DOs: Allopaths and Osteopaths Have Learned to Coexist,” Texas Medicine 93 (April 1997): 34–39; Lydia Hodges, “Symposium on Osteopathic Medicine Featured at Allopathic Convention,” The DO 40 (May 1999): 31–32; Coimbra Sirica, ed., Osteopathic Medicine: Past, Present, and Future (New York: Josiah Macy Foundation, 1996); and idem, Current Challenges to MDs and DOs (New York: Josiah Macy Foundation, 1996).

14. For example see Brian Donadio, “Department of Government Relations,” The DO 26 (October 1985): 178; Eugene Oliveri, “Bureau of State Government Affairs,” The DO 34 (October 1993): 136–37.

15. Jennifer Berger, “State Examiners Discuss FSMB’s Review of COMLEX-USA,” The DO 40 (1999): 31–33; Gerald Osborn, “The Comprehensive Osteopathic Medical Licensing Examination, COMLEX-USA: A New Paradigm for Testing and Evaluation,” JAOA 100 (2000): 1050–51;John Graneto, “Testing Osteopathic Medical School Graduates for Licensure: Is COMLEX—USA the Most Appropriate Examination?” JAOA 101 (2001): 26–32; Lydia Hodges, “While Seeking FSMB’s Endorsement, COMLEX-USA Proves Its Validity,” The DO 43 (May 2002): 52–54; Jill Svoboda, “Louisiana Governor Signs Legal Parity of DOs, MDs into Law,” The DO 42 (July 2001): 41–42.

16. See Norman Gevitz, “The AMA and the Chiropractors: Reflections on the History of the Consultation Clause,” Perspectives in Biology and Medicine 32 (1989): 281–99.

17. For example seeJeffrey Bouley, “Osteopathic Medicine’s Distinction is EPPRC Bone of Contention,” The DO 41 (October 2000): 49–51. Occasionally, DO leaders who strongly identify with the osteopathic profession declare that there is a strong likelihood that allopathic and osteopathic medicine will eventually merge into one profession. However, these expressions, made to MD audiences, are often diplomatic and perfunctory.

18. Data provided by the membership departments of the American Osteopathic Association and the American Medical Association.

19. See Norman Gevitz, “‘Parallel and Distinctive’: The Philosophical Pathway for Reform in Osteopathic Medical Education,” JAOA 94 (1994): 328–32; Wayne Guglielmo, “Are DOs Losing Their Unique Identity?” Medical Economics 75 (April 27, 1998): 201–14.

20. Special Committee on Osteopathic Principles and Osteopathic Technic, Kirksville College of Osteopathic Medicine, “An Interpretation of the Osteopathic Concept: Tentative Formulation of a Teaching Guide for Faculty, House Staff and Student Body,” J Ost 60 (October 1953): 1–10; Sarah Sprafka, Robert Ward, and David Neff, “What Characterizes an Osteopathic Principle? Selected Responses to an Open Question,” JAOA 81 (1981): 29–33. More recently DOs have updated these tenets based upon new scientific understanding from the fields of molecular biology and genetics. See Oliver Hayes and Philip Greenman, “Reprise on a Theme: Osteopathic Principles for the 2 lst Century,” The DO 34 (December 1993): 21–28; Felix Rogers et al., “Proposed Tenets of Osteopathic Medicine and Principles for Patient Care,” JAOA 102 (2002): 63–65.

21. Irvin Korr, “An Explication of Osteopathic Principles,” in Foundations for OsteopathicMedicine 2nd ed., ed. Robert Ward (Philadelphia: Lippincott, William s and Wilkins, 2002), pp. 12–18. See also Michael Seffinger et al., “Osteopathic Philosophy,” in the same volume, pp. 3–12.

22. Jack Leahy, “Manipulation: A Survey of How DOs Feel About It,” UP 38 (March 1972): 31–36.

23. National Center for Health Statistics, Office Visits to Osteopathic Physicians January–Decemher 1974: Provisional Data from the National Ambulatory Medical Care Survey (Washington, D.C., n.d.), p. 19.

24. Lincoln Fry, “Preliminary Findings on the Use of Osteopathic Manipulative Treatment by Osteopathic Physicians,” JAOA 96 (1996): 91–96; Shirley Johnson, Margot Kurtz, and J. C. Kurtz, “Variables Influencing the Use of Osteopathic Manipulative Treatment in Family Practice,” JAOA 97 (1997): 80–87; Aguwa and Liechty, “Professional Identification and Affiliation,” pp. 408–20.

25. Shirley Johnson and Margot Kurtz, “Diminished Use of Osteopathic Manipulative Treatment and Its Impact on the Uniqueness of the Osteopathic Profession,” AcademicMedicine 76 (2001): 821–28.

26. Singer, 2001 Annual Report, p. 38

27. Robert Ward, ed. Foundations for Osteopathic Medicine (1st ed.) (Baltimore: William s and Wilkins, 1996). (The second edition, published in 2002, is cited in note 21 of this chapter.).

28. For the problem of integrating distinctly osteopathic practices in clerkships and postdoctoral training see David Essig-Beatty et al., “Decline in Structural Examination Compliance in the Hospital Medical Record with Advancing Level of Training,” JAOA 101 (2001): 501–8; Harry Friedman et al., “Effects of an Educational Intervention on Documentation of Palpatory and Structural Findings and Diagnosis,” JAOA 96 (1996): 529; Jeffrey Bouley, “Osteopathic Medical Curricula Come Up Short on ’Osteopathy,”’ The DO 41 (October 2000): 45–47; Donald Spaeth and Alfred Pheley, “Evaluation of Osteopathic Manipulative Treatment Training by Practicing Physicians in Ohio,” JAOA 102 (2002): 145–50.

29. Jay Shubrook andjohn Dooley, “Effects of a Structured Curriculum in Osteopathic Manipulative Treatment (OMT) on Osteopathic Structural Examinations and Use of OMT for Hospitalized Patients,” JAOA 100 (2000): 554–58; Warren Magnus and Russell Gamber, “Osteopathic Manipulative Treatment: Student Attitudes Before and After Intensive Clinical Exposure,” JAOA 97 (1997): 109–13; Russell Gamber, Eric Gish, and Kathryn Herron, “Student Perceptions of Osteopathic Manipulative Treatment After Completing a Manipulative Medicine Rotation,” JAOA 101 (2001): 395–400. One recently retired osteopathic physician and dean noted that a requirement for his graduation in 1959 included performing 500 osteopathic manipulative treatments in both his junior and senior years. No such requirement exists currently. See James Stookey, “Lessons from Mecca,” The DO 41 (September 2000): 58–63.

30. John Licciardone and Kathryn Herron, “Characteristics, Satisfaction, and Perceptions of Patients Receiving Ambulatory Healthcare from Osteopathic Physicians: A Comparative National Survey,” JAOA 101 (2001): 374–85. John Licciardone, Russell Gamber, and Kathryn Cardarelli, “Patient Satisfaction and Clinical Outcomes Associated with Osteopathic Manipulative Treatment,” JAOA 102 (2002): 13–20; John Licciardone, Paul Brittain, and Samuel Coleridge, “Health Status and Satisfaction of Patients Receiving Ambulatory Care at Osteopathic Training Clinics,” JAOA 102 (2002): 219–23.

31. For a review of neurophysiologic research by the Kirksville group in the 1960s and 1970s and their implications for osteopathic theory and practice see Irvin Korr, “The Spinal Cord as Organizer of Disease Processes; IV. Axonal Transport and Neurotrophic Function in Relation to Somatic Dysfunction,” JAOA 80 (1981): 451–59.

32. See H. James Jones, “Somatic Dysfunction,” in Ward, Foundationsfiir Osteopathic Medicine, 2nd ed., pp. 1153–61.

33. Deborah Heath and Norman Gevitz, “The Research Status of Somatic Dysfunction,” in Ward, Foundations for Osteopathic Medicine, 2nd ed., pp. 1188–93.

34. William Johnston, M. L. Elkiss, R. V. Marino, et al., “Passive Gross Motion Testing: Part II. A Study of Interexaminer Agreement,” JAOA 81 (1982): 304–8; William Johnston, Myron Beal, G. Blum, et al. “Passive Gross Motion Testing: Part III. Examiner Agreement on Selected Subjects,” JAOA 81 (1982): 309–13. Some researchers prefer the term segmental dysficnction to describe the phenomenon. See William Johnston, B. Allen, J. Hendra, et al., “Interexaminer Study of Palpation in Detecting Location of Spinal Segmental Dysfunction,” JAOA 82 (1983): 839–45.

35. William Johnston,Joseph Vorro, and Robert Hubbard, “Clinical/Biomechanic Correlates for Cervical Function: Part I. A Kinematic Study,” JAOA 85 (1985): 429–37;Joseph Vorro and William Johnston, “Clinical Biomechanic Correlates for Cervical Function: Part II. A Myoelectric Study,” JAOA 87 (1987): 353–67; Joseph Vorro, William Johnston, and Robert Hubbard, “Clinical Biomechanic Correlates for Cervical Function: Part III. Intermittent Secondary Movements,” JAOA 91 (1991): 145–55; Joseph Vorro and William Johnston, “Clinical Biomechanic Cervical Dysfunction: Part IV. Altered Regional Motor Behavior,” JAOA 98 (1998): 317–23.

36. William Johnston, James Hill, M. Elkiss, et al., “Identification of Stable Somatic Findings in Hypertensive Subjects by Trained Examiners Using Palpatory Examination,” JAOA 81 (1982): 830–36; William Johnston, Albert Kelso, and Howard Babcock, “Changes in Presence of a Segmental Dysfunction Pattern Associated with Hypertension: Part 1. A Short—Term Longitudinal Study,” JAOA 95 (1995): 243–55; William Johnston and Albert Kelso, “Changes in Presence of a Segmental Dysfunction Pattern Associated with Hypertension: Part II. A Long-Term Longitudinal Study,” JAOA 95 (1995): 315–18; Myron Beal, “Palpatory Testing for Somatic Dysfunction in Patients with Cardiovascular Disease,” }’A 0A 82 (1983): 822–31; John Cox, Sherman Gorbis, Lorane Dick, et al., “Palpable Musculoskeletal Findings in Coronary Artery Disease: Results of a Double—Blind Study,” }’AOA 82 (1983): 832–36; Myron Beal and George Kleiber, “Somatic Dysfunction as a Predictor of Coronary Artery Disease,” JAOA 85 (1985): 302–7; Alexander Nicholas, Domenic DeBias, Walter Ehrenfeuchter, et al., “A Somatic Component to Myocardial Infarction,” Britt’s/2 Medicaljoum41291 (1985 ): 13–17. Myron Beal and John Morlock, “Somatic Dysfunction Associated with Pulmonary Disease,” JAOA 84 (1984): 179–83; William Johnston, Albert Kelso, Donald Hollandsworth, et al., “Somatic Manifestations in Renal Disease: A Clinical Research Study,” JAOA 87 (1987): 22–35;Jan Lei Iwata, J. Jerry Rodos, Thomas Glonek et al., “Comparing Psychotic and Affective Disorders by Musculoskeletal Structural Examination,” JAOA 97 (1997): 715–20. For a study with negative results and a critique of the methodologies of others see Robert Tarr, Richard Feeley, Daniel Richardson, et al., “A Controlled Study of Palpatory Diagnostic Procedures: Assessment of Sensitivity and Specificity,” JAOA 87 (1987): 296–301.

37. G. B. J. Andersson, T. Lucente, A. M. Davis, et al., “A Comparison of Osteopathic Spinal Manipulation with Standard Care for Patients with Low Back Pain,” New England journal of Medicine 341 (1999): 1426–32. See also the accompanying commentary by Joel Howell, “The Paradox of Osteopathy,” pp. 1465–68. For the origins of this study see John Sprovieri, “AOA Launches Study of OMT, Back Pain,” The DO 33 (September 1992): 60–61.

38. See New England journal of Medicine 342 (2000): 817–20 for letters on the study and the accompanying commentary. See also Gilbert D’Alonzo, “What Is the Standard of Care for Patients with Low Back Pain,” JAOA 99 (1999): 556; Jennifer Berger, “Top Journal Backs OMT,” The DO 41 (February 2000): 28–33.

39. See Sandra Sleszynski and Albert Kelso, “Comparison of Thoracic Manipulation with Incentive Spirometry in Preventing Postoperative Atelectasis,” JAOA 93 (1993): 834–45; W. Randolph Purdy, Jesse Frank, and Brent Oliver, “Suboccipital Dermatomyotonic Stimulation and Digital Blood Flow,” JAOA 96 (1996): 285–89; Kelly Jackson et al., “Effect of Lymphatic and Splenic Pump Techniques on the Antibody Response to Hepatitis B Vaccine: A Pilot Study,” JAOA 98 (1998): 155–60; Michael Wells et al. “Standard Osteopathic Manipulative Treatment Acutely Improves Gait Performance in Patients with Parkinson’s Disease,” JAOA 99 (1999): 92–98; Donald Noll et al., “Benefits of Osteopathic Manipulative Treatment for Hospitalized Elderly Patients with Pneumonia,” JAOA 100 (2000): 776–82; Russell Gamber et al., “Osteopathic Manipulative Treatment in Conjunction with Medication Relieves Pain Associated with Fibromyalgia Syndrome: Results of a Randomized Clinical Pilot Project,” JAOA 102 (2002): 321–25.

40. Kristie Aylett and Scott Stoll, “Introduction to the Texas College of Osteopathic Medicine at the University of North Texas Health Science Center at Ft. Worth,” American Academy of Osteopathy journal 11 (Winter 2001): 13–17; “The Profession’s Emerging Research Center,” JAOA 101 (2001): 323–24; Jacquie Goetz, “Rekindling Research,” The DO 43 (April 2002): 22–25; idem, “Research Progress,” The DO 43 (April 2002): 26–27. For other schools see idem, “Getting Off the Ground,” The DO 43 (April 2002): 28–30.

41. One survey was conducted for the AOA by BSMG and Wirthlin World-wide in early 1999. The other survey was conducted by the Gallup Organization for the AACOM. For published earlier data seeJay Lindquist, “Patient Confusion and Misperception About the Doctor of Osteopathy and the Medical Doctor,” Journal of Health Care Marketing 8 (March 1988): 76–81; Charles Lamb, Ronald Haverstad, and Wade Lancaster, “Consumer Perceptions About Doctors of Osteopathy and Medical Doctors,” Journal of Health Care Marketing 8 (December 1988): 53–57.

42. A number of DOs have been the subject of favorable local media coverage although it is rare for them to get national media attention for their accomplishments. When Elton Lehman DO of Ohio was named “country doctor of the year” by a Texas-based locum tenens firm he was featured in USA deay, People, and Parade. See “Ohio Doctor Named Country Doctor of the Year,” The DO 39 (November 1998): 21–26. Sister Ann Brooks, an osteopathic physician as well as a nun, who practices in Mississippi in one of the poorest counties in the nation, has been featured on the television program 60 Minutes as well as in national magazines and newspapers for her medical missionary work. See Marilyn Soltis, “Dr. Brooks Finds Reward in Serving God’s Underserved,” The DO 33 (February 1992): 102–08. It is also rare for the profession itself to get any coverage from national media. An exception is Abigail Zuger, “Scorned No More, Osteopathy on the Rise,” New Hark Times (February 17, 1998): B9, B12.

43. Norman Gevitz, “Visible and Recognized: Osteopathic Invisibility Syndrome and the 2% Solution,” JAOA 97 (1997): 168–70; Eckberg, “The Dilemma of Osteopathic Physicians,” pp. 1111–20.

44. For media and public education efforts of the 1980s and early 1990s see for example Walter Wilson, “PR Report,” The DO 22 (June 1982): 65–66; Al Boeck, “Department of Communications,” The DO 26 (October 1985): 156–57; Donald Krpan, “Committee on Public Relations,” The DO 33 (October 1992): 124–25; “Critics Give AOA Practice Marketing Kit Rave Reviews,” The DO 33 (March 1992): 18 passim. Since 1980 the Ohio University College of Osteopathic Medicine has produced a weekday three-minute radio program called “Family Health” which is currently broadcaSt on about 300 radio Stations across the country each day. It identifies its current host, Harold Thompson III, as either an osteopathic physician or a DO.

45. Howard Levine, “Would You Like the DO to Become a Household Word?” The DO 33 (March 1992): 16. The national “unity campaign” had its origins in the activities of two state societies, Michigan and New Jersey, in the early 1990s. See Daniel Bade, “All for One,” The DO 34 (January 1993): 70–79. For the national campaign see Jennifer Berger, “Getting the Word Out: Unity Campaign Promoters Profession to Public,” The DO 40 (August 1999): 26 passim; Jacquie Goetz, “Creating the DO ‘Brand,"’ The DO 41 (November 2000): 28–33. The Tucson Osteopathic Medical Foundation has for years conducted an effective local public education campaign. See Jeffrey Bouley,”Promotion of DOs Blazing Away in Tucson," The DO 41 (October 2000): 34–38.

46. The extent of the media relations and public education problem is illustrated by what occurred in the December 2001 issue of Self magazine. The AOA had placed an advertisement on page 94. On page 54 of the same issue in a brief article entitled “When to Look for an MD Degree” the author stated quite remarkably, “If you have complicated health problems, stick with an MD. But if you’re basically healthy, there’s little reason not to see an osteopath; a DO has the same residency training as an MD.” See “DOs Respond to Inaccurate Reporting,” The DO 43 (March 2002): 19–20.

47. John Crosby, “The Road to Be Taken: AOA Leadership on Complementary and Alternative Medicine,” The DO 43 (June 2001): 11–12.

48. It is beyond the scope of this book to discuss developments in osteopathy internationally. In the past two decades, interest in traditional osteopathic philosophy and methods has widened in Europe, Asia, Canada, Australia, New Zealand, and elsewhere. Since these international schools and practitioners neither teach nor embrace the full practice of medicine, DOs in this country have not yet agreed on what relations they should maintain with these groups. See John Sprovieri, “Academy Holds Global Forum on Osteopathic Practice,” The DO 37 (June 1996): 43–45; Michael Fitzgerald, “AOA Trustees Create International Affairs Committee,” The DO 37 (June 1996): 29–33; Lydia Hodges, “AOA Council Explores International Role for AOA,” The DO 39 (May, 1998): 24–31.

49. George Thomas, “Bureau of State Government Affairs,” The DO 39 (October 1998): 104; John Sprovieri, “Extenders or Independents,” The DO 35 (August 1994): 68471; Lydia Hodges, “Physicians Need to Forge New Relationships with Non-physician Clinicians,” The DO 41 (June 2000): 66–69. See also Natalie Holt, “‘Confusion’s Masterpiece’: The Development of the Physician Assistant Profession,” Bull Hist Med 72 (1998): 246–78.

50. Christopher Durso, “Osteopathic As They Wanna Be,” The New Physician 46 (May—June 1997): 16–22; Shirley Johnson and David Bordinat, “Professional Identity: Key to the Future of the Osteopathic Medical Profession in the United States,” JAOA 98 (1998): 325–31; Katherine Miller, “The Evolution of Professional Identity: The Case of Osteopathic Medicine,” Social Science and Medicine 47 (1998): 1739–48; Aguwa and Liechty, “Professional Identification and Affiliation,” pp. 408–20. For an internal view of the prospects of osteopathic medicine see R. Michael Gallagher and Frederick Humphrey II, eds., Osteopathic Medicine: A Reformation in Progress (New York: Churchill Livingstone, 2001).