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

3. In the Field

Although a few of Still’s early graduates remained in Kirksville to serve as assistants in the infirmary, the majority went out into the field to establish their own private practices. A directory published in 1900 listing 717 graduates shows 121 (16.8 percent) residing in Missouri, 84 (11.7 percent) in Iowa, 83 (11.7 percent) in Illinois, 48 (6.6 percent) in Ohio, 32 (4.4 percent) in Pennsylvania, 31 (4.3 percent) in New York, and 30 (4.2 percent) each in Indiana and Tennessee, with the rest scattered throughout thirty-five other states and territories.1 Some returned to their hometowns to begin work, while others were recruited by well-to-do patients to accompany them back to their city of origin to continue the treatment. Under such sponsorship the osteopath was formally introduced to the entire community.

Establishing a Practice

The most important task for the freshly settled DO was to create a favorable impression on the townspeople. The system was new and in many areas unheard of. Often the term osteopathy was a handicap; quite a few prospective patients took it to mean that DOs thought all ailments were due to diseased bones or that they only treated fractures and dislocations. A few of Still’s students recognized the potential problem and pleaded with him to change the name. He remained adamant. “I don’t care what Greek scholars say,” he bristled, “I want to call my boy osteopathy.”2

In their advertisements in local papers or in printed brochures and journals, DOs explained that osteopathy was a totally original and independent system of health care. Several pointed out that it had “nothing in common with faith cure, Christian Science, spiritualism, hypnotism, mag netic healing, Swedish Movements, mental science, or massage.”3 Many in their audience, however, remained skeptical. All of those systems and others could involve, as did osteopathy, the “laying on of hands.” Therese Cluett, DO, of Cleveland, found that this shared trait led to much misunderstanding:

A lady entered my office and asked ifI was a theosophist. I said, “No madam, I am an osteopathist.” “Oh well,” she replied, “It’s all the same thing.” Then it took me fully an hour to explain the difference between theosophy and 05teopathy. On another occasion, I was approached with the question “Are you a Christian? because I don’t want to take treatment from anyone who is not a Christian.” This fairly caught my breath… I asked her if she had put the same question to [her last physician] that she had put to me. She replied that she had not. It took me another hour to explain the difference between osteopathy and Christianity. For one patient I had to insulate the table, as they think this is some form of magnetic treatment. The next patient spies the insulators (as I had forgotten to remove them) and then there is trouble, as this patient won’t have anything along that line of business.4

Cluett’s problem was shared by Herbert Bernard, DO, who noted, “When I first came to Detroit, a woman telephoned me asking what price I charged to pray for people. Another one looked all over one of my operating tables trying to find the electric wires that he thought were hidden… Quick results were dangerous in those days, as the patients would think there had been some rabbit’s foot business worked upon them. They were afraid to tell of their relief … thinking people would take them for faith-cure followers.”5

In explaining their system and differentiating it from others, many osteopaths told their patients that they alone could be considered “anatomical engineers.” Only DOs knew where every bone, muscle, nerve, or blood vessel should be and what significance each held in the maintenance or restoration of health. Several of them published descriptions that were eloquently worded and simple to understand. If one accepted the metaphor of “man as a machine,” the osteopath’s logic made sense. As a violin or engine needed tuning or adjustment every so often, so also did the human body.

On the other hand, a good number of practitioners preferred the hard-sell approach, which, though less dignified, was nonetheless successful in drawing attention. “Osteopathy,” said one appeal, “deserves your patronage because it has demonstrated its ability to do all medicine can do and much more. Many are the diseases entirely beyond the reach of the medical attendant that promptly surrender to the ability and the knowledge of the osteopath. In other words, there is not a single thing that medical men can surpass osteopaths in except … malpractice or killing people.”6

Quite a few DOs published lists of the diseases that they claimed to be especially successful in treating. One typical advertisement included “headache, granulated eyelids, deafness, dripping eyes, dizziness, pterygium, polyps of the nose, cattarrh, constipation, torpid liver, gall stones, neuralgia of the stomach and bowels, dysentery, flux, piles, fistula, irregularities of the heart, kidney disease, female diseases, rheumatism and neuralgia of all parts, atrophy of the limbs, paralysis, locomotor ataxia, varicose veins, milk leg eczema, nervous prostration, hip joint disease, curvature of the spine, etc.”7 Some placed arbitrary recovery percentages next to disorders, such as one list, which reported these cure rates: sleeplessness, 95 percent; back pain, 90 percent; stomach trouble, 75 percent, dropsy, 65 percent; withered limbs, 60 percent; deafness, 55 percent; and cancer, 30 percent.8 Others gave overall figures. “We cure about eighty-five percent of the cases we take,” declared one infirmary, “benefit ninety-five percent, and fail on five percent.”9

Another advertising method was the testimonial. Gratified patients would give the practitioner permission to publish flattering letters they had written. In defending this approach, the Matthews and Hook Infirmary declared, “Osteopathy is a great discovery. Its theory is most reasonable. But it has a practical side as well as a reasonable theory. And while it is perfectly proper to give its principles, its scientific basis, and speak in general terms of what it can do, it is also eminently necessary to take evidence and hear testimony from those who have tried it… The question that the world asks is ‘Does it work?’ Osteopathy works. And for the benefit of those who wish to investigate we shall give from time to time the names and addresses of some who have thoroughly tested it.”10

Most of the individuals throughout the country who patronized the early DOs suffered from chronic complaints similar to those found among patrons who came to Kirksville. “During our twenty months practice in Nashville,” Dr. J. R. Schackleford noted, “we had many cases of interest, some of whom had gone the rounds of the medical profession, patent medicine, sanitariums, springs, mountains, sea shore, and various other devices and places for relief. Many who came said to us ‘We have tried everything else and now we are willing to try osteopathy.’ This is the rule in most cases, but whether we are the first or last makes but little difference to us so [long as] we get the desired results.”11 Though some of the clinic reports sent into the Journal of Osteopathy concerned acute infectious disorders, these represented a minor portion of the average osteopathic workload. As W L. Riggs, DO, wrote, “The idea is generally prevalent among the laity, wherever osteopathy is known, that the science is peculiarly adapted to long-standing and chronic cases, but that its results are too slow to counteract the rapid processes which follow the conditions prevailing in what are commonly called acute diseases.”12

Patients were generally told that quick cures were the exception rather than the rule. Most DOs agreed with Dr. A. L. Evans, who observed:

The over sanguine osteopath who advertises, writes, and talks constantly about cases that are remarkable for the rapidity with which they have yielded to the osteopathic treatment does himself and the profession an injustice. People are led to expect miracles… It is wise to explain to them that it will take time to eliminate poisonous drugs from their system and to induce healthy normal action in torpid organs that have long been dependent upon extraneous stimulation. It is far better to impress this upon them than to tell wonderful storiesno matter how true–of marvelous cures effected in one or two treatments. By the latter method the patient is led to expect the same results in his own case and may be disappointed, for nature, though sure, is sometimes slow. If, on the other hand, more is accomplished than promised, osteopathy has won a friend that will never falter in allegiance to our system.13

To encourage this type of thinking, DOs generally billed their patients by the month, charging the standard fee for four weeks of treatment of $25. If the client’s condition required an extended period, a sliding scale of charges was often worked out.

One problem generated by this arrangement was that patients expected as many sessions within the month as possible, regardless of their ailment. As a result, it became a matter of custom to administer no more than three treatments per week per client. Therese Cluett wrote of one supplicant who wanted “a treatment ‘everyday’ as Mrs. So-and-so goes to Dr. 50and-so and he gives a treatment ‘everyday.’ I say ‘All right’ knowing well it is only a question of time until she will beg off. In a week the patient is so prostrated by the frequent treatment that she is glad to admit she cannot stand so much osteopathy. It is all I can do to get her three times a week which is as much as anyone can stand without becoming debilitated.”l4

Since each of these encounters could last up to one hour, fatigue on the part of the patient as well as the practitioner can easily be imagined.

Of the early DOs in the field who contributed letters to the journal of Osteopathy and other periodicals, almost all boasted that they were making a good living. In 1898 Joseph Sullivan, DO, declared, “Osteopathy in Chicago is on the high road to success. We are treating more people now than at any time during ’97 and our results are most gratifying.” Drs. F. W. and Mrs. Hannah noted, “Our patients now number three score of the leading people in Detroit and vicinity including representatives from almost every profession and avenue of business.”15 Drs. Mason Pressly and O. J. Snyder of Philadelphia claimed, “Within so short a time as a year… our books show that we are treating considerably over a hundred patients every month.”16 In explaining the osteopath’s success, A. L. Evans listed several major factors: First, the theory of osteopathy was a rational and commonsense one; there was nothing “vague, mysterious, or occult about it.” Second was the plain and reasonable plan of charges, “a system whereby the patient is enabled to tell approximately what it is going to cost him to regain his health.” Third, manipulation was much more palatable to the patient than medicine or surgery: “If osteopathy did nothing but abolish experimental doses of poisonous drugs and curtail the number of blood operations it would be worthy of the gratitude of countless sufferers.” And finally, Evans argued, “nothing succeeds like success. It is results that tell.”17

Such missives of self-congratulation did not give a complete accounting of the situation generally for DOs, however. Each issue of the journal would also contain notices by many DOs of their change of address, often from town to town. For them, osteopathy was not a sure-paying proposition, and not a few dropped out of practice altogether.18 In many instances the business failure of the osteopath was due to public apathy; in others, an inability to impress his or her clientele was to blame. For some, it was a matter of the local MDs’ employing existing medical licensing acts to drive them out before they had a chance to get settled in.

Legal Struggles

The posture of orthodox physicians towards osteopaths varied considerably. Some regarded DOs as harmless quacks whose clienteles would patronize any new healer who happened to arrive in town. A few thought that their “rubbing” might be indicated in selected cases and would even refer an occasional patient or two. Most often an MD’s response was shaped by the behavior of the DO. If the latter went quietly about his or her own business, there was usually small chance of confrontation. However, the osteopath who arrived in town with much fanfare, making extravagant claims regarding his or her own skill while intimating that the MDs were in league with the undertakers, was simply asking to be prosecuted. Whenever arrests did take place, the DOs would maintain that jealousy and fear were the prime motivating factors. Once they had begun to prove they were superior doctors, their argument ran, the MDs in self defense would have to do all they could to get rid of them. While many did depart after being hauled before the courts, other osteopaths stayed to fight, and in the great majority of instances they managed to win.

The first legal action regarding a D0 in the field appears to be the case of Charles Still (1865–1955), the founder’s son, who had been invited to practice in Red Wing, Minnesota. When he arrived in 1893 he found himself in the midst of an epidemic of what had been diagnosed by local doctors as diphtheria. Though his experience to date had been with chronic disorders, Still was soon called upon to treat a victim. After his patient made a rapid recovery following conscientious applications of manipulative treatments to the neck, shoulders, and head, Still was asked to care for upwards of seventy children with reportedly only one fatality as a result. The State Board of Health, despite his apparent success, authorized his arrest for practicing without a license. By the time the case came up for trial Still’s work had generated such considerable public support that the MD who had initiated the suit decided not to make an appearance, and the matter was dropped.19

Audrey Moore, DO, a graduate of the American School of Osteopathy’s second class, was practicing in Macon, Illinois, when he was jailed on a similar charge. In his defense, Moore produced patients who testified that he had benefited or cured them when their MD had given up hope. “After examining a number of my witnesses,” he recalled, “none of whom had seen any medicines used, and all of whom felt better after treatment, the justice said from the bench that all the people seemed to want to try this new humbug, so he would discharge the prisoner.”"

A few DOs were even emboldened to initiate legal action against challenging MDs. In 1898 Harry Nelson, DO, who had been practicing in Louisville for about a year, became tired of the threats issued by the Kentucky Board of Health that he had better leave town or prepare himself for incarceration. In his suit, Nelson demanded that the board examine and license him or else cease and desist. When the matter came to trial Nelson’s patients testified on his behalf; but unlike in the Moore case, the presiding judge was not impressed. Instead he listened to john McCormack, MD, of the American Medical Association, who maintained that “to license Dr. Nelson would be dangerous to the health, limbs, and lives of those citizens who might be treated by him in most instances.” Though he had lost that round, Nelson would not give up his fight. The following year he brought his case to the Court of Appeals, which reversed the original decision and granted a permanent injunction against the board from preventing any DO from engaging in his profession. “So long as he confines himself to osteopathy, without the use of medicine or surgical appliances,” the court ruled, “he violates no law and appellee should not molest him.”21

What constituted the practice of medicine became the primary legal point at issue in most of the state courts that entertained such suits. MD representatives argued that the term medicine as found in the various healing arts statutes should be construed in its widest possible sense, while the DOs maintained that it meant the practice of administering drugs–and nothing more. In Alabama the state Supreme Court took the side of the MDs, deciding, “It is made entirely clear both by definitions and history that the word medicine has a technical meaning, is a technical art or science, and as a science the practitioners of it are not simply those who prescribe drugs, or other medical substances as remedial agents, but that it is broad enough to include all persons who diagnose disease and prescribe or apply any therapeutic agent for its cure.”22 However, only the Nebraska judiciary agreed. All other high courts ruling before 1904–Colorado, New York, North Carolina, Mississippi, Virginia, Ohio, and New Jersey–concurred with Kentucky that the term medicine should be narrowly interpreted.23 “In forbidding an unlicensed person to apply any drug or medicine for remedial purposes,” said the New Jersey high court, “the legislature plainly contemplated the use of something other than the natural facilities of the actor; some extraneous substance.”24

In addition to their judicial struggle, both the MDs and the DOs traveled legislative avenues, appearing before a number of state legislatures to present their respective cases: the former sought specifically to outlaw the new system, while the latter wished to establish standards governing its practice. The DOs’ first successful effort came in Vermont. Physicians in and nearby the town of Chelsea had become upset over the activities of Dr. George Helmer, who had established an osteopathic infirmary there in 1895. As Helmer’s clientele grew the MDs complained to the state’s attorney that the new healer was a public menace who preyed upon the weak-minded. Since several of the official’s friends were among those being treated, their demands for prosecution were not looked upon favorably. This prompted the Vermont Medical Association to call upon the legislature for relief. Apprised of this, Helmer temporarily moved his offices to the capital to fight. While he was there, several lawmakers with chronic health problems decided to find out for themselves the relative merits of osteopathy by willingly submitting to his treatments. A number of them, including the lieutenant governor, were most pleased. As a consequence the legislature decided to throw out the medical society’s bill, substituting and passing one giving any graduate of the American School of Osteopathy the right “to practice their art of healing in the state.”25

Next in line to regulate the new system was North Dakota. Though DOs were involved in this lobbying effort, the battle was primarily waged by a patient, Helen DeLenderecie, the wife of “the merchant prince of Fargo.” Her motivation was well expressed in a letter she wrote to the journal of Osteopathy:

In the fall of 1895, a lump appeared in my right breast. Our family physician advised its immediate removal assuring me that nothing but the knife could remedy the evil, and stating that it would soon assume a malignant form if not removed without delay. Knowing him to be a fine surgeon as well as a physician, I placed myself in his hands and submitted to an operation whereby my entire breast was removed. It was a great shock to my nervous system, and I had not recovered from it, when the same trouble appeared in my left breast. I had heard meantime of osteopathy and resolved to try it before again submitting to the knife… I went to Kirksville and was completely cured in six weeks time. My own eyes saw and my own hands felt the obstruction that caused the trouble in both cases, and I knew very well that the knife was never necessary… Osteopathy has clearly proven its right to recognition in the healing of cases heretofbre declared only curable by the knife, and it is only right that its supporters should sustain its claim.26

When the bill came up for a vote in the Senate, DeLenderecie was given the unusual privilege of speaking to the entire body in its support. After hearing her dramatic story and her rebuttals of some of the arguments put forward by the MDs, the legislature passed the measure, and the governor, another osteopathic patient, happily signed it.27

In 1901 Mark Twain appeared before the New York State Assembly to speak on behalf of a bill legalizing osteopathy. To a gallery of cheering admirers Twain noted, “The State stands as a mighty Gibraltar clothed with power. It stands between me and my body and tells me what kind of doctor I must employ… I know how Adam felt in the Garden of Eden about the prohibited apple. Adam didn’t want the apple until he found out he couldn’t have it, just as he would have wanted osteopathy if he couldn’t have it.”28 In a private letter Twain wrote, “I want osteopathy to prosper; it is common sense, and scientific and cures a wider range of ailments than the [orthodox] doctor’s methods can reach.”29

The New York bill was not enacted and battles in several other jurisdictions were also hard fought. Nevertheless, in addition to Vermont and North Dakota, thirteen other states had by 1901 established laws regulating the new system–Missouri (1897), Michigan (1897), Iowa (1898), South Dakota (1899), Illinois (1899), Tennessee (1899), Montana (1901), Kansas (1901), California (1901), Indiana (1901), Nebraska (1901), Wisconsin (1901), and Connecticut (1901).30 Many orthodox physicians had first thought osteopathy only a fad, but it became increasingly apparent to them that the actions of most courts and some legislatures were encouraging its growth and subsequent institutionalization.31 At the turn of the century, when the American Medical Association was making considerable progress in eliminating the homeopathic and eclectic schools through a process of absorption, here was yet another competitor challenging the hegemony of orthodox medicine.32

Other Schools

While the fight in the courts and legislatures was in progress, a number of Still’s graduates were forming their own colleges. The first were the National School of Osteopathy (1895) of Kansas City, the Pacific College of Osteopathy (1896) in Los Angeles, and the Northern Institute of Osteopathy of Minneapolis (1896). Within a few years the products of these schools, as well as of the American School of Osteopathy, established colleges in Boston, Philadelphia, San Francisco, Des Moines, Milwaukee, Chicago, Denver, and in smaller cities such as Wilkes-Barre, Pennsylvania; Ottawa, Kansas; Franklin, Kentucky; Fargo, North Dakora; Keokuk, Iowa; and Quincy, Illinois. Most of these institutions grew out of existing infirmaries where some clients, experiencing the benefits of osteopathy first hand, were anxious to become practitioners themselves. Instead of sending them to Kirksville, the proprietors, with an eye towards supplementing their income, were willing to organize their own programs. By 1904, of the estimated four thousand DOs in practice, approximately one-half were graduates of these other schools.33

The physical plants of these other colleges initially consisted of a small suite of rooms in an office building or a converted private residence. Since the first few classes were small, such facilities were seen by their operators as more than adequate. Entrance standards were nominal. While a number of catalogs called for a high school diploma, students lacking one found little difficulty gaining admittance, provided they were able to pay their fee in advance. Tuition was generally set at the American School of Osteopathy’s original figure of $500 for the complete course, but because of competition it was soon lowered to a more reasonable $300—$350, which in turn increased the number of matriculants.

At first there were no common standards relating to the length and breadth of the curriculum. Some colleges, following the American School, limited their instruction to several months of anatomy, osteopathic diagnosis, and therapy, while others took it upon themselves to increase the time necessary for graduation as well as the number of subjects covered. Indeed, the Pacific College was the first to adopt a curriculum consisting of four terms of five months each which included broad basic science instruction.34 When Still followed suit, months later, most of the other colleges decided to go along.

The teaching staff of these schools was small, generally between three and ten professors depending on the number of students enrolled. In some cases a majority of the instructors did not possess a DO degree or have any previous osteopathic training. MDs who wanted to learn something of osteophathic techniques as an adjunct to their own practice were pressed into teaching some subjects in lieu of part or the whole of their tuition fee. In almost all cases, MDs, whether they served on the faculty or not, were automatically given advanced standing, allowing them to complete the requirements for their diploma in approximately half the normal time.35

The equipment in these institutions varied markedly. Whereas the American School, the Des Moines School, and the Pacific College were able to move quickly into large, spacious facilities and furnish their laboratories with microscopes, dissecting and chemical analysis kits, and the newly invented x-ray machine, many others seem to have gotten along with a treatment table, a skeleton, and a few wall charts.36

In urging prospective students to enroll, each catalog made osteopathy appear to be a great calling and focused on the inner satisfaction one could expect by healing people in this “natural drugless way.” However, if this was not sufficient motivation, there was always the appeal to one’s mercenary interest. “The experience of graduates of osteopathy, who are now practicing in various parts of the country,” claimed the Des Moines College, “demonstrates conclusively that there is no profession at this time in existence where a young man or woman can earn money so rapidly and successfully as in the practice of osteopathy. We have data in our office to show that good, scientific graduates of osteopathy can go out and earn from $250 to $500 per month, and in some cases their earnings reach as high as $800 a month.”37 The Northern Institute of Minneapolis was even more encouraging, declaring, “Osteopathy is the business opportunity of one’s life time. There is increasing demand for it. No student properly equipped has made a failure of it. Individuals are making in cash from $500 to $1 ,000 per month. We know men who couldn’t earn $1,000 a year who are now making $1,000 per month.”8

Another argument ran that, whereas there might be as many as a dozen MDs in a small community, there would be a single DO who, after curing but a few of his or her counterparts’ failures, would be swamped with business. An early catalog of the Philadelphia College observed, “There are not yet 400 osteopaths in the country, with a population of 75,000,000. The supply is short … the demand is great and there is no competition. This opens up a highway to success.”39 Correspondingly, the Atlantic School in Wilkes–Barre noted, “Fifty or one hundred years hence the profession will be crowded, but it will not be while we live. Those first in any field are the ones that reap the harvest–not the gleaners.”40

Special appeals were directed at prospective female candidates. Since they were then denied entrance to all but a handful of regular medical schools, here was an alternative method of becoming a doctor. “The science of osteopathy appeals to women who desire a noble, uplifting work,” the Pacific College reasoned. “A woman whose natural inclination is toward the benefit and assistance of the less fortunate of human kind, and who desires to allay herself with some work that while acting constantly as a moral uplift, will yet in an agreeable and rapid way place her peculiarly above all concern for the future, has the basis furnished her in osteopathy.”41 Such inducements were apparently quite successful, since approximately one-fifth of all graduates of osteopathic schools before 1910 were women.42

Each college naturally pointed to itself as the most advantageous institution in which to learn to become an osteopath. In addition to citing the alleged quality of their respective facilities, equipment, and staff, many focused on the environmental conditions of the city in which their school was located. “Franklin,” said the Southern School, “is a noted health resort having several mineral wells whose properties are seldom excelled.”43 Similarly, the Pacific College declared Los Angeles to be “the best place in the world to study hard and maintain one’s bodily vigor.”44 The Des Moines College even made a contrast between its town and the Missouri Mecca, claiming its “streets are well improved and the climate is exceptionally healthy,” while Kirksville, because of supposedly poor sanitary conditions, “was rapidly becoming a hotbed for typhoid and malarial fever.”45

Relations between these new colleges and the American School of Osteopathy were at best tepid and at worst openly hostile. Still believed that few if any of his early graduates had either the training or the practical experience to teach osteopathy on their own; that their institutions, for the most part, did not match the standards of the American School of Osteopathy; and finally, since some of them were situated within a few hundred miles of Kirksville, that they were in open competition for students who should rightfully be his.

The American School of Osteopathy declared war on the National School of Osteopathy in nearby Kansas City, Missouri, almost from its inception. The National School, headed by Elmer and Helen Barber, two graduates of the American School’s second class, offered a regular course of instruction that was somewhat briefer than the one found at the parent institution, and it was rumored that its diplomas could be bought for a price. Elmer wrote the first book ever published on osteopathy, and in it he claimed that Still was wrong on a number of important theoretical issues and that anyone could learn to treat common ailments manipulatively with his text as the only necessary aid.46 Not surprisingly, MD groups found Barber’s work a most useful illustration of their contention that osteopathy was a fraud.

As a result of these goings-on, Still and his associates were placed on the defensive; they did all they could to dissociate themselves from and repudiate the Barbers, Elmer’s book, and the National School. Dr. William Smith, who had entered practice for a brief time after teaching the first class and who had thus never met the twosome, was dispatched to Kansas City to determine whether the Barbers were complying with the new state law that required a college to give twenty months of personal instruction before awarding a diploma.47 Meeting Elmer under an assumed name, Smith identified himself as an MD who knew all about osteopathy though he did not have the benefit of a DO degree. Barber, in turn, offered to issue him one on the spot for $150, a sum Smith agreed to and then paid. He next stopped at the attorney general’s office, where he presented the bogus diploma and related the facts of the case, all of which led to the Barbers’ indictment. Although the court found the pair guilty of violating the new statute, the judge refused to accede to the prosecutor’s demand that their charter be revoked, finding that Smith’s actual medical and osteopathic education mitigated the seriousness of the offense. After paying a small fine, the Barbers continued as before. Only in 1900, when their operation proved to be unprofitable, did they voluntarily decide to close their doors, but not before bestowing degrees on at least fifty individuals, some of whom established their own diploma mills, such as Noe’s College of Osteopathy in San Francisco and Payne’s College of Osteopathy and Optics in Ottawa, Kansas.48

Even more galling to Still than the Barbers’ institution was the Columbian School of Osteopathy, located almost across the street from the American School and run by a former associate, Marcus Ward (18491929). Brought to Kirksville on a stretcher in 1890, Ward looked to Still for relief from a severe asthmatic condition. After he was restored to health, Ward entered into a business arrangement with his benefactor to learn his methods. Still later took him on as one of his assistants in the infirmary, and when Still established the American School of Osteopathy in 1892 Ward became a major stockholder and served as vice-president under the first charter. Within months after the college opened, however, the two had a falling out, and eventually Ward left town. He relocated in Ohio, enrolling in the medical department of the University of Cincinnati. After obtaining his MD degree there in 1897, Ward moved back to Kirksville. There, with the help of local businessmen who believed the town was large enough for two osteopathic institutions, he established the Columbian School.49

In his advertising Ward declared himself the “co-founder of osteopathy” and claimed to have been working along the same lines as Still since 1862, when he was thirteen years old. He also called himself the sole originator of what he named “True Osteopathy,” which was the combination of materia medica, surgery, and manipulation. The use of all three therapeutic modalities, said Ward, would reestablish the “true” approach to healing as practiced by the ancient Greeks. Columbian students were therefore taught the principles of drug therapy along with other subjects now found in the expanded American School of Osteopathy curriculum. After they completed their twenty-month course and received the DO degree, they could enroll for another year of medical and surgical training, upon completion of which they would be granted the MD.50

Still did not address Ward’s remarkable claim of being the co-discoverer of osteopathy. This he left to his friends and associates.51 He did, however, sharply lash out at Ward’s inclusion of materia medica in his curriculum. “Every man and woman sick and tired of drugs, opiates, stimulants, laxatives, and purgatives has turned with longing eyes to this rainbow of hope,” he thundered, speaking of Kirksville, “and yet these medical osteopaths are trying to paint this rainbow with calomel and perfume it with whiskey.” Ward’s college, he opined, was a mongrel institution that, like the bat, is “neither bird nor beast.” Anyone who pays his money into this institution, he claimed “gets neither medicine nor osteopathy, but a smattering, enough to make a first class quack.”52

In its first two years of operation, the Columbian School attracted a fair number of matriculants; however, internal disputes between Ward and his financial backers would thereafter rack the college, and the institution closed in 1901 after graduating perhaps as many as seventy individuals. Once again the “co-founder” left town, settling in California, where for the next quarter-century he practiced in relative obscurity.53 Though ostracized from the movement and quickly forgotten, Ward, with his efforts at fully integrating drug therapy into the osteopathic system, was a harbinger of battles to come.



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