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[[File:Andrew_Taylor_Still_1914.jpg|left|thumbnail|250px|Andrew Taylor 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.
====The Birth of Osteopathy====
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>
While practicing magnetic healing, Still added bonesetting to his practice to attract more patients. Bonesetters alleviated pain by moving bones back into alignment. Bonesetting had been practiced since colonial times, and these specialists were dispersed widely throughout the country. After learning the bonesetter trade, Still became convinced that bonesetting could do more than just address simple aches and pain. He argued that it had the potential to cure chronic conditions such as asthma.<ref>Gevitz, 17-19</ref>
Not only were the 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 three major medical sects for patients. While Osteopaths primarily treated patients for chronic conditions, they argued that Osteopathy could treat other types of diseases and deserved to be viewed as more than simply a system of body manipulation.<ref> Gevitz, 42.</ref> From their patients’ perspectives, Osteopaths performed the same services as licensed physicians. Osteopaths achieved their results by different methods, but their clients would have viewed Osteopaths as doctors. When licensing and state boards of health prosecuted Osteopaths for practicing medicine, Osteopaths argued that they were not physicians despite their public pronouncements to the contrary. From a legal perspective, Osteopaths made a credible argument. They contended that they did not practice medicine because they did not prescribe drugs. 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 healers. Osteopaths wanted to be seen as more than just nurses.<ref> State v. Gordon, 194 Ill. 560, 62 N.E. 858 (1902)</ref>
====Illinois prosecutes Eugene Holt Eastman Osteopaths for the illegal practice of medicine====Eugene Holt Eastman was one of the first Osteopaths prosecuted for practicing Osteopathy. Eastman was unique because he was tried in two separate states, Illinois and Ohio, for practicing Osteopathy in two consecutive years. He was a graduate of the newly formed American School of Osteopathy in Kirksville, Missouri. <ref> Eastman v. Ohio, 6 Ohio Dec. 296, 297 (1897).</ref>As a practicing Osteopath, Eastman’s treatment “consisted wholly of rubbing and manipulating the affected parts with his hands and fingers, and flexing and moving the limbs of the patient in various ways.” <ref> Eastman v. People, 71 Ill. App. 236, 238 (1896).</ref> Eastman argued to the Illinois Board of Health that he was not a practicing physician because he did not prescribe medicine or use instruments to treat his patients. <ref> Eastman, 238.</ref> The Illinois board ignored his arguments and determined that he was a physician. The Illinois board ruled that Eastman was a physician 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 limbs. Both the Illinois board and the court of appeal simply defined medicine as “the art of understanding diseases and curing or relieving them when possible.” <ref>Eastman, 239.</ref> Under this definition, Eastman was found to be practicing medicine and his conviction was upheld.
After the Illinois board’s decision, Eastman left Illinois and moved to Akron, Ohio, late in 1896. In Akron, he continued his Osteopathic practice, but within one month he was charged with practicing medicine without a license. Contrary to the Illinois Court of Appeals, the Court of Common Pleas in Ohio did not believe that Eastman was a practicing physician. The court refused to find that Osteopaths, clairvoyants, mind healers, faith -curers, massage therapists, and Christian Scientists were physicians under the Ohio licensing statute. If the legislature sought to ban or regulate these practices, the court argued it would need to do so explicitly, as Iowa had done.In 1899, the Ohio Supreme Court in State <ref> Eastman 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 circuit 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 medicine299-301.”</ref>
In Nelson 1899, the Ohio Supreme Court in State v. State Board Liffring supported the earlier lower court decision in the Eastman case and confirmed that Osteopathy did not constitute the practice of Healthmedicine in Ohio. A grand jury indicted William Liffring for practicing with a license, an Osteopath named Harry Nelson filed a petition of equity but went to enjoin the Kentucky State Board of Health from harassing himcircuit court and quashed the indictment. Nelson was concerned that The state sought to overturn the board was going to lower court’s decision and prosecute him Liffring for violating the state’s practice and he sought to short circuit their effortslicensing law. They refused to enjoin the board from enforcing Prosecutors argued that medicine had “a wider significance than has the law against Nelsonword drug. ” After They also cited “The Ohio Osteopath,” which was published by the lower Law and Equity Division entered a judgment in favor faculty of the board, Nelson asked the Kentucky Ohio Institute of Osteopathy. This publication identified fifty diseases that could be treated successfully by Osteopathy. The court of appeals to reverse the decision disagreed and force found that the board to recognize his college, practice of medicine required the American College use of Osteopathy in Kirksville“drug or medicine.”<ref> State v. Liffring, 61 Ohio St. 39; 55 N.E. 168 (1899), as legitimate under the state’s medical practice act39-51.</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 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.
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.
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