Changes

Andrew T. Taylor Still, a former Regular physician from Missouri, developed the treatments that morphed into Osteopathy during the 1870s and 1880s. In 1874, Still renounced Regular medicine and became a magnetic healer. Magnetic healers passed magnets over a patient’s body to restore the flow of the “invisible magnetic fluid” that circulated throughout the body. Magnetic healing was developed in Austria in late eighteenth century and migrated to the United States. Magnetic healers postulated that people became ill when this fluid pooled inside the body instead of flowing freely.<ref> Gevitz, Norman, <i>The DOs: Osteopathic Medicine in America</i>, 2nd edition, (John Hopkins University Press, Baltimore, 1982, 2004), 13-15. </ref>

====Medical Boards begin to prosecute Confusion over Osteopathsstatus====

Just as Regulars had demonized Homeopaths and Eclectics in the past, licensed physicians from the three medical sects worked together and relentlessly attacked these new medical specialists. Licensing united the three sects against these new interlopers. While the sects still viewed medicine somewhat differently, their differences were not nearly as great as those between them and these new medical apostates. Additionally, Regulars, Eclectics, and Homeopaths dominated medical licensing, and they did not want these specialties to flourish unchallenged. Licensed physicians directed their state organizations to prosecute Osteopaths and Christian Scientists.<ref> Martin Kaufman, Homeopathy in America: The Rise and Fall of Medical Heresy (The Johns Hopkins University Press, Baltimore, 1971), 141-142.</ref> ====Courts determine whether Osteopathy is medicine====There were several early decisions that addressed whether Osteopaths needed to be licensed as physicians under existing licensing laws. Typically, Osteopaths defended themselves by claiming that they were not physicians and did not fit within the existing licensing laws. In Missouri, the state legislature passed an exemption in 1892, but Osteopathy presented a conundrum for most state courts. Courts struggled to develop a consensus on whether Osteopathy was a practice of medicine. Interestingly, courts ended up analogizing Osteopathy to Christian Science. Typically, if courts believed that Christian Science was a medical practice, then they would come to the same conclusion about Osteopathy. Not only were the court decisions at odds<ref> In Nebraska, but Osteopaths also were forced to make contradictory arguments about their medical specialty. They advertised that their medical system could cure numerous ailments. They also were competing with physicians from the three major medical sects for patients. While Osteopaths primarily treated patients for chronic conditions, they argued that both Osteopathy could treat other types of diseases and deserved Christian Science were found to be viewed as more than simply a system of body manipulationmedical practices. From their patients’ perspectives, Osteopaths performed the same services as licensed physiciansSee Little v. Osteopaths achieved their results by different methodsNebraska, but their clients would have viewed Osteopaths as doctors60 Neb. When licensing 749 (1900) and state boards of health prosecuted Osteopaths for practicing medicine, Osteopaths argued that they were not physicians despite their public pronouncements to the contraryNebraska v. From a legal perspective, Osteopaths made a credible argument. They contended that they did not practice medicine because they did not prescribe drugsBuswell 58 N. It may have been a solid argument in court to compare to Osteopaths to nurses or massage therapists, but it also would also have undermined their credibility as legitimate healersW. Osteopaths wanted to be seen as more than just nurses728 (1894).</ref>

====Illinois prosecutes Eugene Holt Eastman for Not only were the illegal practice of medicine===Eugene Holt Eastman was one of court decisions at odds, but Osteopaths also were forced to make contradictory arguments about their medical specialty. They advertised that their medical system could cure numerous ailments. They also were competing with physicians from the first Osteopaths prosecuted three major medical sects for practicing Osteopathypatients. Eastman was unique because he was tried in two separate statesWhile Osteopaths primarily treated patients for chronic conditions, Illinois they argued that Osteopathy could treat other types of diseases and Ohio, for practicing Osteopathy in two consecutive years. He was deserved to be viewed as more than simply a graduate system of the newly formed American School of Osteopathy in Kirksvillebody manipulation.<ref> Gevitz, Missouri42. As a practicing Osteopath</ref> From their patients’ perspectives, Eastman’s treatment “consisted wholly of rubbing and manipulating Osteopaths performed the affected parts with his hands and fingerssame services as licensed physicians. Osteopaths achieved their results by different methods, but their clients would have viewed Osteopaths as doctors. When licensing and flexing and moving the limbs state boards of the patient in various ways.” Eastman health prosecuted Osteopaths for practicing medicine, Osteopaths argued to the Illinois Board of Health that he was they were not a practicing physician because he did not prescribe medicine or use instruments physicians despite their public pronouncements to treat his patientsthe contrary. The Illinois board ignored his arguments and determined that he was From a legal perspective, Osteopaths made a physiciancredible argument. The Illinois board ruled They contended that Eastman was a physician they did not practice medicine because he stated that his treatments could cure a “long list of diseases” relying only on the “manipulation, flexing, rubbing, extension” of his client’s limbsthey did not prescribe drugs. Both the Illinois board and the It may have been a solid argument in court of appeal simply defined medicine to compare to Osteopaths to nurses or massage therapists, but it also would also have undermined their credibility as “the art of understanding diseases and curing or relieving them when possiblelegitimate healers.” Under this definition, Eastman was found Osteopaths wanted to be practicing medicine and his conviction was upheldseen as more than just nurses.<ref> State v. Gordon, 194 Ill. 560, 62 N.E.858 (1902)</ref>

After ====Illinois prosecutes Osteopaths for the illegal practice of medicine====Eugene Holt Eastman was one of the Illinois board’s decisionfirst Osteopaths prosecuted for practicing Osteopathy. Eastman was unique because he was tried in two separate states, Eastman left Illinois and moved to Akron, Ohio, late for practicing Osteopathy in 1896two consecutive years. In Akron, he continued his Osteopathic practice, but within one month he He was charged with practicing medicine without a license. Contrary to the Illinois Court graduate of Appeals, the Court newly formed American School of Common Pleas Osteopathy in Ohio did not believe that Kirksville, Missouri.<ref> Eastman was a practicing physicianv. The court refused to find that OsteopathsOhio, clairvoyants6 Ohio Dec. 296, mind healers297 (1897).</ref>As a practicing Osteopath, faith curers, massage therapistsEastman’s treatment “consisted wholly of rubbing and manipulating the affected parts with his hands and fingers, and Christian Scientists were physicians under flexing and moving the limbs of the Ohio licensing statutepatient in various ways. ”<ref> If the legislature sought to ban or regulate these practicesEastman v. People, the court argued it would need to do so explicitly, as Iowa had done71 Ill. App.In 1899236, the Ohio Supreme Court in State v238 (1896). Liffring supported </ref> Eastman argued to the earlier lower court decision in the Eastman case and confirmed Illinois Board of Health that Osteopathy he was not a practicing physician because he did not constitute the practice of prescribe medicine in Ohioor use instruments to treat his patients. A grand jury indicted William Liffring for practicing with a license<ref> Eastman, but went to circuit and quashed the indictment238. </ref> The state sought to overturn the lower court’s decision Illinois board ignored his arguments and prosecute Liffring for violating the state’s licensing lawdetermined that he was a physician. Prosecutors argued The Illinois board ruled that medicine had “a wider significance than has the word drug.” They also cited “The Ohio Osteopath,” which Eastman was published by the faculty a physician because he stated that his treatments could cure a “long list of diseases” relying only on the Ohio Institute “manipulation, flexing, rubbing, extension” of Osteopathyhis client’s limbs. This publication identified fifty diseases that could be treated successfully by Osteopathy. The court disagreed Both the Illinois board and found that the practice court of appeal simply defined medicine required the use as “the art of “drug understanding diseases and curing or relieving them when possible.”<ref>Eastman, 239.</ref> Under this definition, Eastman was found to be practicing medicineand his conviction was upheld.”

After the Illinois board’s decision, Eastman left Illinois and moved to Akron, Ohio, late in 1896. In Nelson vAkron, he continued his Osteopathic practice, but within one month he was charged with practicing medicine without a license. State Board Contrary to the Illinois Court of HealthAppeals, an Osteopath named Harry Nelson filed a petition of equity to enjoin the Kentucky State Board Court of Health from harassing him. Nelson was concerned Common Pleas in Ohio did not believe that the board Eastman was going to prosecute him for violating the state’s practice and he sought to short circuit their effortsa practicing physician. They The court refused to enjoin find that Osteopaths, clairvoyants, mind healers, faith-curers, massage therapists, and Christian Scientists were physicians under the board from enforcing the law against NelsonOhio licensing statute. After If the lower Law and Equity Division entered a judgment in favor of the boardlegislature sought to ban or regulate these practices, Nelson asked the Kentucky court of appeals argued it would need to reverse the decision and force the board to recognize his collegedo so explicitly, the American College of Osteopathy in Kirksvilleas Iowa had done.<ref> Eastman v. Ohio, as legitimate under the state’s medical practice act299-301.</ref>

In 1899, the Ohio Supreme Court in State v. Liffring supported the earlier lower court decision in the Eastman case and confirmed that Osteopathy did not constitute the practice of medicine in Ohio. A grand jury indicted William Liffring for practicing with a license, but went to the circuit court and quashed the indictment. The state sought to overturn the lower court’s decision and prosecute Liffring for violating the state’s licensing law. Prosecutors argued that medicine had “a wider significance than has the word drug.” They also cited “The Ohio Osteopath,” which was published by the faculty of the Ohio Institute of Osteopathy. This publication identified fifty diseases that could be treated successfully by Osteopathy. The court disagreed and found that the practice of medicine required the use of “drug or medicine.”<ref> State v. Liffring, 61 Ohio St. 39; 55 N.E. 168 (1899), 39-51.</ref>  <dh-ad/> In Nelson v. State Board of Health, an Osteopath named Harry Nelson filed a petition of equity to enjoin the Kentucky State Board of Health from harassing him. Nelson was concerned that the board was going to prosecute him for violating the state’s practice and he sought to short-circuit their efforts. They refused to enjoin the board from enforcing the law against Nelson. After the lower Law and Equity Division entered a judgment in favor of the board, Nelson asked the Kentucky court of appeals to reverse the decision and force the board to recognize his college, the American College of Osteopathy in Kirksville, as legitimate under the state’s medical practice act.<ref> Nelson v. State Board of Health, 108 Ky. 769, (1900), 770-774.</ref>  The Kentucky Court of Appeals determined that American College of Osteopathy was not a reputable medical college, but it still found in Nelson’s favor. The court found that Osteopathy did not constitute the practice of medicine and it was unnecessary to for the board to evaluate Nelson’s school. The court stated that because Osteopaths did not prescribe drugs or conduct surgery, they were not physicians. Therefore, Nelson’s medical speciality specialty was not covered by the Kentucky medical practice act, and the state’s board of health had absolutely no right to interfere. The American College of Osteopathy was not a legitimate medical school because its graduates did not practice medicine. The court cited Liffring in support of its decision. <ref>Nelson, 779-781</ref>

The Supreme Court of Nebraska also wrestled with a similar question of whether Osteopathy was a recognizable part of the practice of medicine. Charles Little, an Osteopath, was convicted of practicing medicine without a license. Little argued at trial that he was not a physician under the Nebraska medical practice act. The Nebraska Supreme Court rejected Little’s argument and found that “those who practice osteopathy for compensation come within the purview of the statue as clearly as those who practice what is known as ‘Christian Science,’ and therefore this case f[ell] within the principle of State v. Buswell.” While the court acknowledged that other courts’ decisions around the country were “in conflict with it,” it was satisfied with its decision because Osteopaths and physicians had the same goals. They both sought to restore “the patient to sound bodily or mental condition.” The court was not interested in quibbling over whether the practice of medicine required physicians to prescribe drugs. <ref>Little v. Nebraska, 60 Neb. 749 (1900), 751-752.</ref>

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 diagnose diagnoses diseases and prescribe 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. ====Osteopaths lobby legislatures for protection from prosecution====[[File:1200px-Illinois_House_of_Representatives.jpg|left|370px|thumbnail|Illinois House of Representatives]]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.<ref> Gevitz, 47.</ref>

Since, the courts were deadlocked over the issue of Osteopathy, Osteopaths quickly realized that the only way to ensure the survival of their medical speciality was to lobby for their own licensing laws. While a majority of courts exempted Osteopaths from licensing laws, Osteopaths wanted their practice to be 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 state were in the Midwest, but New York, California, and Connecticut also passed laws favoring Osteopaths. These new laws were not ideal. In order to secure medical licensing, Osteopaths lobbied in favor of laws that were not always particularly beneficial to them. They struggled to get traction in state legislatures, because Osteopaths were hampered by their small numbers, the relative youth of the specialty, disorganized campaigns, and lack of agreement among themselves about the type of laws that were most appropriate. In many states, efforts to secure legislation flamed out. In the states where Osteopaths secured licensing, they often were placed at the mercy of licensing boards that they did not have any representation on.

One of these states was Illinois which passed a new licensing law in 1899 designed to license Osteopaths and other medical specialists. Under the new law, the practice of medicine was broadly defined to include physicians who practiced medicine and surgery in all their branches and anyone who wished to practice a specific system of medicine without the use of medicine or instruments. This law was designed to put the state board of health in charge of all medical practitioners including midwives, Osteopaths and potentially Christian Scientists. Physicians from the three major medical sects controlled the board and Osteopaths had little say over how the law was administered. Even under the 1887 medical practice act, practitioners who rubbed or manipulated their patients were classified as physicians. <ref>Eastman v. People, 71 Ill.App. 236 (1896).</ref>  Suffice it to say, the state’s new law did not necessarily help Osteopaths. Under Illinois law, Osteopath Osteopaths were required to meet the same standards as all other physicians. They were not given a lower standard to become a physician in the state. Laws like Illinois‘ would require Osteopathic schools of medicine to rethink their school’s curriculum to help their students pass licensing exams.

Still, Osteopaths did benefit from a majority of courts’ unwillingness to interfere with their practice rights. Despite the split between the courts, a clear majority ruled that Osteopathy did not constitute the practice of medicine. In some ways, these decisions suggested that the ambivalence expressed earlier by courts about medical licensing in general. They did not hesitate to hobble these laws because of sloppy drafting or overreaching provisions. By finding Osteopathy to be outside the practice of medicine, a majority of courts sent a clear message to state legislatures that they would not allow an expansion of who was a physicians physician without explicit legislation classifying Osteopath as doctors. While these decisions typically favored Osteopaths, the outcome was still problematic. These court decisions essentially stated that Osteopaths were not equal to physicians as healers. If Osteopaths wanted to be considered by the public to be legitimate, they needed to gain state validation.  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.<ref> Dudley Tait, M.D., “Report of the Committee on Medical Education,” California State Journal of Medicine, Vol. VI, No. 5 (1908): 161, http://books.google.com/ebooks.</ref> 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.<ref>Gevitz,54-56</ref>

By 1923, Osteopaths already had been somewhat successful in establishing secured licensing laws in several forty-six states between 1892 and 1904, but they wanted to create about half of those states created separate licensing osteopathic boards controlled by Osteopaths and expand the legislative recognition of their sect. With separate boards, Osteopaths could develop their own criteria for licensure established a secure foothold in America and increase the status of legitimate practicing Osteopathshave never relinquished it. In California aloneContrarily, after the newly major sects established Osteopathic board between 1901 unified boards and 1907 issued more than nine hundred certificates the AMA admitted Irregulars to practice Osteopathy. Even as Regulars, Homeopathsits ranks, Eclecticism and Eclectics were moving toward unified boards, Homeopathy began their slow decline. Osteopaths realized that separate boards could preserve their unique successfully transformed themselves from a small Midwestern medical sectinto physicians in the eyes of both the public and the law.

The American Osteopathic Association developed a model law that was similar to licensing laws used to create Regular, EclecticToday, Osteopaths and Homeopathic boardsMDs are virtually indistinguishable. Osteopathic physicians throughout During the country pushed for licensing based on this model. While they did not always succeed20th Century, as historian Norman Gevitz pointed out, this effort was fairly effectiveOsteopaths slowly moved away from Andrew Still's drugless treatments. Despite pushback from Medical licensing allowed osteopaths to transform the three major sectarian medical sects, Osteopaths secured practice rights in thirty-nine states doctrine that had defined them and created seventeen independent boards around still be distinct from MDs. Instead of being subsumed by the country by 1913. By 1923regulars, Osteopaths secured licensing in forty-six states and about half of those states created separate osteopathic boardswere allowed to transform their medical practices. Osteopaths established a secure foothold in America Currently, there are over 34 American Osteopathic medical schools and have never relinquished it. Contrarilyover 130, after 000 osteopaths practicing medicine across the major sects established unified boards and the AMA admitted Irregulars to its ranks, Eclecticism and Homeopathy began their slow declineUnited States.