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[[File:Andrew_Taylor_Still_1914.jpg|left|thumbnail|250px|Andrew Still, founder of the Osteopathic Medicine in 1914]]
In the last quarter of the 19th Century in the United States, Osteopathy posed a significant challenge to existing physicians. At the end of the 19th century, medicine in America was dominated by three separate competing medical sects - regular (M.D.), homeopaths and eclectic physicians. Each sect advanced competing theories explaining the causes of disease and illness. The emerging science surrounding germ theory threatened to upend the medical doctrine of all three sects. Osteopaths, on the other hand, dismissed scientific medicine entirely. Osteopaths manipulated the body to treat their patient's health. Because of Osteopaths unusual treatments, the newly created medical licensing boards around the United States struggled with whether their practice constituted the practice of medicine.
Unlike the court in Little, the Alabama Supreme Court’s decision focused directly on the notion of whether the practice of medicine required use of medicines. In Bragg v. State, E. Eugene Bragg was convicted by the Jefferson County Criminal Court of practicing medicine without a license and violating the Alabama medical practice act. Bragg appealed to the state’s supreme court to overturn his conviction. Bragg’s defense was that he was not engaged in the practice of medicine because he did not use medicines. The court rejected his claim and stated “the word medicine has a technical meaning, is a technical art or science, and as a science the practitioners are not simply those who prescribe drugs or other medicinal substances as remedial agents, but it is broad enough to include and does include all person who diagnoses diseases and prescribes or apply any therapeutic agent for its cure.” The court cited Bibber v. Simpson in support of its decision. As discussed earlier in Bibber, the Maine Supreme Court determined that the actions of a medical clairvoyant constituted the practice of medicine. Bragg is another example of a court that took a broader interpretation of what constituted the practice of medicine.
Since the courts were deadlocked over the issue of Osteopathy, Osteopaths quickly realized that the only way to ensure the survival of their medical specialty was to lobby for their own licensing laws. While a majority of courts exempted Osteopaths from licensing laws, Osteopaths wanted their practice to not only be legal throughout the country but legitimate. Like Regulars and Irregulars, Osteopaths quickly organized themselves in medical societies and created research journals. Aside from giving Osteopaths a sheen of respectability, the infrastructure gave Osteopaths a way to wage a concerted campaign to secure licensing. Between 1897 and 1901, fifteen states passed separate licensing laws for Osteopaths. Unsurprisingly, most of these states were in the Midwest, but New York, California, and Connecticut also passed laws favoring Osteopaths.
Osteopaths already had been somewhat successful in establishing licensing laws in several states between 1892 and 1904, but they wanted to create separate licensing boards controlled by Osteopaths and expand the legislative recognition of their sect. With separate boards, Osteopaths could develop their own criteria for licensure and increase the status of legitimate practicing Osteopaths. In California alone, the newly established Osteopathic board between 1901 and 1907 issued more than nine hundred certificates to practice Osteopathy. Even as Regulars, Homeopaths, and Eclectics were moving toward unified boards, Osteopaths realized that separate boards could preserve their unique sect.
====Conclusion====The American Osteopathic Association developed a model law that was similar to licensing laws used to create Regular, Eclectic, and Homeopathic boards. Osteopathic physicians throughout the country pushed for licensing based on this model. While they did not always succeed, as historian Norman Gevitz pointed out, this effort was fairly effective. Despite pushback from the three major medical sects, Osteopaths secured practice rights in thirty-nine states and created seventeen independent boards around the country by 1913. By 1923, Osteopaths secured licensing in forty-six states and about half of those states created separate osteopathic boards. Osteopaths established a secure foothold in America and have never relinquished it. Contrarily, after the major sects established unified boards and the AMA admitted Irregulars to its ranks, Eclecticism and Homeopathy began their slow decline. Osteopaths successfully transformed themselves from a small Midwestern medical sect into physicians in the eyes of both the public and the law. Today, Osteopaths and MDs are virtually indistinguishable. Osteopaths have almost abandoned the teachings of Andrew Still that defined osteopathy at the end of the 19th century. There are over 34 Osteopathic medical schools and over 130,000 osteopaths practicing medicine across the United States.
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