[To the Editor of the SPECTATOR.] SIR,—For many years now
I have been a diligent reader of the Spectator with, I believe, great profit to myself. I have admired your calm and unbiased attitude towards affairs of the moment and unconsciously I have been led to model my own views on yours. But now my peace of mind has received a rude shock. I have begun to wonder whether after all your opinions are based, as I have hitherto believed, on a profound knowledge of facts or whether they are expressions merely of a passing whim.
The paragraph which has so disturbed me is that referring to the recognition of osteopaths.
The training of a medical student nowadays differs in no way from that of any other student of applied science and, indeed, of any student of modern trades and handicrafts. He com- mences by learning by practical methods the exact structure of the human body. He has previously had instruction in com- parative anatomy, but now he learns with the most complete attention to detail the components of the body by the slow method of systematic dissection. He has to dissect, and while dissecting learn the exact positions and functions of every portion of his subject. It is a long business, and to many a tedious business, but it is rightly held that unless we know exactly the composition of the machine it is impossible to get a clear view of its functions. Fortunately for the student Nature deviates but very slightly from the "sealed pattern and equally fortunately generations of highly skilled dissectors have catalogued every minute portion of the body so that the student has text-books and atlases whereby he can learn his curious geography. Meanwhile, in the sister science of physiology he is being taught exactly what these components do and how they do it. Physiology employs the two sciences of physics and chemistry. Philosophical contemplation finds no part in its armament. Everything has to be proved by the accepted methods of the physicist and chemist.
When, and only when, the student has satisfied the governing bodies that he has a competent knowledge of anatomy and physiology he is then allowed to begin the study of the body in disease. The methods adopted are exactly the same. The pathologist and the bacteriologist with their microscopes and incubators form the backbone of modern medicine. In every teaching centre there are men who spend their lives in research, in the ceaseless prying into nature's secrets. Take up any scientific medical journal and you will be bound to find at least one paper expressing the results of one or more years' research some matter which is connected with the welfare of the body. So it goes on in exact parallel with any other science. And there is only one way in which this knowledge can be obtained.
There is no short cut. If there were, if it were possible to get the required knowledge without all the laborious dissection, all the work in the physiological laboratories, you may rest assured that some of us would have found it and employed it to our Own ease.
The modern motor mechanic who is properly trained at a technical school follows exactly the same lines. He has to pull the whole machine to pieces and learn exactly why any part is
there and what it does. •
The " osteopaths " cut out all the preliminary work on anatomy and physiology. They ignore it. They can then invent an anatomy of their own. You see, you must be a medical student if you want facilities for dissection. 'The law looks askance at unauthorized anatomy schools, nowadays. So the osteopath simply ignores it. No one can learn anatomy from a text-book only. You must dis:sect and dissect carefully and diligently.' There is no other way. The chiropractors go one better and ignore physiology as well. They attribute to the spine and its marrow functions which have never yet been- discovered by the patiently plodding physiologist, and having premised these functions proceed with the irremedial treatment on is purely fictitious basis. I admit that good has been done by the so-called manipu- lative surgery. There is no doubt about it, and the successes have been extensively advertised. Also there is equally no doubt that a lot of harm has been done by the same methods but the failures are never advertised. My point is this : Why, because it has to do with human life, relieve a branch of healing from the necessity of knowing the fundamentals of the subject ? Because a man is a fluent and persuasive speaker, the Bar Council does not relieve him of the necessity of learning the elements of law and of satisfying their examiners that he has learnt these elements. Even 'a plumber nowadays has • to satisfy the local authority that he has learned his trade in an accepted school before he is allowed to register and interfere with their water and gas supplies.
With the enormous growth of medical knowledge an in- creasing number of special branches has arisen. Public Health, Tropical Medicine, Ophthalmic Surgery, Radiology, to name a few, each has now its special degree or diploma granted by a University or similar corporation. But these qualifications are granted only after the general and funda- mental training has been completed. They are supplementary always.
One other point. Those who know what a course of training in the United States can mean, do not attach much weight to the recognition by that country of" qualified osteopaths." It would interest you to read accounts that have recently been published here of the training adopted in some of the American medical schools. But it would not edify you.
By the way, this manipulative surgery is not confined to osteopaths. There is a number of qualified or as you say "orthodox " surgeons who have for a long time included move- ments in their armament, of treatment, but no qualified medical man is allowed to advertise. There is the difference.—I am, Sir, &c., A GENERAL PRACTITIONER OF MEDICINE.
[We can assure our correspondent that our advocacy of legal recognition for osteopaths and chiropractors is not "a passing whim," but is founded on a careful consideration of the growing belief of the public that doctors combine to discountenance new methods in healing out of self interest. We do not believe this ourselves, but neither do we see what harm the legal recognition of osteopaths can do to the medical profession. The public will go to those who it believes can cure it. If it chooses the regularly qualified doctor it has a guarantee of hiscompetence and respectability. If it chooses an Osteopath, by all means let it have a properly qualified practitioner therein.—En. Spectator.]
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