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The Art and Science of Osteopathic Medicine

  • Robert Orenstein
Published/Copyright: May 1, 2019
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Journal of Osteopathic Medicine
From the journal Journal of Osteopathic Medicine Volume 119 Issue 5

In this issue of The Journal of the American Osteopathic Association (JAOA), we embark on a new series entitled the Art and Science of Osteopathic Medicine.

The JAOA is creating this new section to enhance the education of our readers on the pathogenesis of common problems seen by generalist physicians. Articles in this section will begin with a brief clinical vignette followed by an up-to-date review of the pathogenesis of the condition. These articles should link the discussion to osteopathic principles, and the conclusion should be hypothesis generating to stimulate further work in the area.

Why create this new section? Most osteopathic physicians are engaged in the care of patients. We practice the art of osteopathic medicine every day by partnering with our patients to uncover solutions to their health needs. But to advance our understanding and improve solutions, we need to have a more in-depth and up-to-date understanding of why patients present with certain syndromes and how we might learn more to help them. How can we, as osteopathic physicians, help restore our patients to health? Scientific inquiry and scholarly activity can enhance and advance that art of care.

One hundred eighteen years ago, in its very first issue, the JAOA published a paper from J. Martin Littlejohn, DO, titled “Osteopathy an Independent System Co-extensive With the Science and Art of Healing.”1 In his paper, Littlejohn tells us that “Osteopathy is that science or system of healing which emphasizes . . . the diagnosis of disease by physical methods with a view to discovering, not the symptoms but the causes of disease.”1(p25) Yes, pathogenesis—understanding the causes of the disease and how the host responds to restore health. The application of therapeutics to restore homeostasis can be achieved through numerous means: physical, nutritional, pharmacological, and environmental.

Littlejohn wondered how osteopathy and the germ theory of disease could be integrated. He explained, “the germ or microbe organism is simply a foreign cell trying to insinuate itself into the mass of cells forming the organism.” He continued, “We have in our throats and lungs the germs of pneumonia and other diseases, from which we are rendered immune, because we have the germicide.”1(p32) Although Littlejohn and Andrew Taylor Still, MD, DO, believed that that germicide was blood, the osteopathic concept was later expanded to understand that the body has many intrinsic mechanisms to protect itself from microbes.

The first article of this series tackles an all too common health problem, recurrent Clostridium (or Clostridioides) difficile infection.2C difficile is a toxin-mediated diarrheal illness that affects more than half a million people in the United States annually,3 particularly elderly people and patients with chronic disease. In this first Art and Science of Osteopathic Medicine article, the pathogenesis of this common infection and how the human host has evolved mechanisms to prevent this illness are reviewed.2 The aforementioned comments of Littlejohn are prescient as we learn that the most effective means for preventing recurrence is restoration of the normal microbial structure of the human colonic microbiome—yes, we do have the germicide.

From the Division of Infectious Diseases at Mayo Clinic Arizona in Phoenix. Dr Orenstein is the editor in chief of the American Osteopathic Association.

*Address correspondence to Robert Orenstein, DO, Editor in Chief, 142 E Ontario St, Chicago, IL 60611-2864. Email:

References

1. Littlejohn JM . Osteopathy an independent system co-extensive with the science and art of healing. J Am Osteopath Assoc. 1901;1(1):22-34.Search in Google Scholar

2. Orenstein R , PatronRL, SevilleMT. Why does Clostridium difficile recur?J Am Osteopath Assoc.2019;119(5):322-326. doi:10.7556/jaoa.2019.054Search in Google Scholar PubMed

3. Lessa FC , MuY, BambergVM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-834. doi:10.1056/NEJMoa1408913Search in Google Scholar PubMed

Accepted: 2019-01-07
Published Online: 2019-05-01
Published in Print: 2019-05-01

© 2019 American Osteopathic Association

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Articles in the same Issue

  1. LETTERS TO THE EDITOR
  2. Doming the Diaphragm in a Patient With Multiple Sclerosis
  3. SURF
  4. Can Osteopathic Medical Students Accurately Measure Abdominal Aortic Dimensions Using Handheld Ultrasonography Devices in the Primary Care Setting?
  5. EDITORIAL
  6. The Art and Science of Osteopathic Medicine
  7. LETTERS TO THE EDITOR
  8. Renal Calculi Passage While Riding a Roller Coaster Has Ayurvedic Roots
  9. CORRECTION
  10. Correction
  11. AOA COMMUNICATION
  12. Official Call: 2019 Annual Business Meeting of the American Osteopathic Association
  13. Proposed Amendments to the AOA Constitution and Bylaws
  14. ORIGINAL CONTRIBUTION
  15. Gender Differences in Sexual Health Knowledge Among Emerging Adults in Acute-Care Settings
  16. Osteopathic Manipulative Medicine Consultations for Hospitalized Patients
  17. BRIEF REPORT
  18. Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures
  19. REVIEW
  20. Cynefin Framework for Evidence-Informed Clinical Reasoning and Decision-Making
  21. ART AND SCIENCE OF OSTEOPATHIC MEDICINE
  22. Why Does Clostridium difficile Infection Recur?
  23. CASE REPORT
  24. Complicated Withdrawal Phenomena During Benzodiazepine Cessation in Older Adults
  25. CLINICAL IMAGES
  26. Fetal Nuchal Cord
https://doi.org/10.7556/jaoa.2019.046
Creative Commons
BY-NC-ND 4.0

Articles in the same Issue

  1. LETTERS TO THE EDITOR
  2. Doming the Diaphragm in a Patient With Multiple Sclerosis
  3. SURF
  4. Can Osteopathic Medical Students Accurately Measure Abdominal Aortic Dimensions Using Handheld Ultrasonography Devices in the Primary Care Setting?
  5. EDITORIAL
  6. The Art and Science of Osteopathic Medicine
  7. LETTERS TO THE EDITOR
  8. Renal Calculi Passage While Riding a Roller Coaster Has Ayurvedic Roots
  9. CORRECTION
  10. Correction
  11. AOA COMMUNICATION
  12. Official Call: 2019 Annual Business Meeting of the American Osteopathic Association
  13. Proposed Amendments to the AOA Constitution and Bylaws
  14. ORIGINAL CONTRIBUTION
  15. Gender Differences in Sexual Health Knowledge Among Emerging Adults in Acute-Care Settings
  16. Osteopathic Manipulative Medicine Consultations for Hospitalized Patients
  17. BRIEF REPORT
  18. Effects of Cannabis Use on Sedation Requirements for Endoscopic Procedures
  19. REVIEW
  20. Cynefin Framework for Evidence-Informed Clinical Reasoning and Decision-Making
  21. ART AND SCIENCE OF OSTEOPATHIC MEDICINE
  22. Why Does Clostridium difficile Infection Recur?
  23. CASE REPORT
  24. Complicated Withdrawal Phenomena During Benzodiazepine Cessation in Older Adults
  25. CLINICAL IMAGES
  26. Fetal Nuchal Cord
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