Changes

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====

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>

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.

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>

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>

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.

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.

====References====

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