Osteopathy was conceived as therapy by Dr. Andrew Taylor Still in Kirksville, USA, in the second half of the 19th century. Still, disappointed by the results and ideas of the medicine of his time he would devote himself to the study of favourable conditions for health without deepening the disease.

A man of strong religious convictions, he was convinced that God had created the human being as a perfect creature. From a mechanical point of view, Still considered that if the structures of the body were aligned and maintained a proper functioning, and while the blood, lymphatic and nervous fluids were not hindered by any cause or reason, health would never be altered.

For Still, the Osteopath must strive to get “the vital impulse” to all the tissues for which, he will concentrate on removing all the mechanical obstacles that hinder the free movement of vital forces; It will be on the basis of this postulate that he will try to understand the internal functioning of the body by applying the anatomical and physiological knowledge existing in his time and using his hands to release joints and relax muscular tensions, taking care not only of patients with serious mechanical problems but also of patients with a large number of pathologies demonstrating the holistic spirit of osteopathy at that time.

There were Still’s direct disciples who continued the evolution and diffusion of osteopathy and in particular, John Martin Littlejohn, who created the first European school of osteopathy in Britain in 1917, which meant the landing of osteopathy in the old continent made which supposes the division in the evolution of this one. Thus, in Europe, osteopaths practice, for the most part, a therapy outside classical medicine while in the USA, osteopaths are trained as doctors. Therefore, American osteopaths use allopathic remedies as supplements to their treatments while in Europe, osteopaths remain faithful to the traditional manual therapy.


The principles of osteopathy are the elementary, general and theoretical rules on which the correct practice of the Osteopath is based and they must always be present in order not to divert or confuse this practice with the already existing ones. As a general rule, five biological principles are known:

– The body is an indivisible unit.

– The structure and the function are interdependent. Movement is life.

– The body endowed with a high degree of perfection gives itself the possibility of self-regulation, self-defence and self-healing.

– The rule of the artery: The correct flow of body fluids is essential to maintain a good state of health. Nerves play a key role in the control of the body fluids and so in the exchange of information between systems.

– The centre of attention is the patient and not the disease considering the individual as a global unit with his own personality, his vital space and his development.


Every session of osteopathy has set some objectives, an intention or a goal, which are intended to be achieved through treatment:

– correction of mechanical disorders.

– restoration of the mechanical structures mobility of the body.

– Stimulate the body’s self-regulation mechanisms.

– favour the body’s innate abilities for self-defence and repair.

– restore the ability to adapt lost when the body’s self-regulation abilities have been exceeded.

– correct and avoid those factors that contribute to the maintenance of the disease.

– and of course, awaken in the body the “vital impulse” asleep during the disease.


Over time, diverse and new concepts have been added to the primary concept of osteopathy. William G. Sutherland expanded and developed the concept of Still in the skull joints. The cranial sutures are mobile and give the skull the structure of a dynamic and deformable puzzle. His studies, findings and clinical observations have allowed the treatment of the cranial sphere to be added to osteopathy. For Sutherland, a skull with normal mobility reflects a good state of health while a skull with mobility restrictions will result in a state of systemic disease.

Sutherland defined:

  • the existence of a system of union between the skull and the sacrum
  • the anatomy-physiological components of the primary respiratory mechanism (PRM)
  • the importance of this mechanism in the organization and control of all the great functions of the body
  • the physiological action of the cerebrospinal fluid acting as a “tide” distributed throughout the whole body through a large net of microtubes and fascias.

Visceral osteopathy is the other branch that integrates the global osteopathic treatment along with joint and cranial osteopathy. Still’s writings show that by then he was already manipulating the visceras integrating them into the body’s mechanical system. After him, different approaches to place in the early twentieth century in the USA, but it has been more recently in Europe where osteopaths such as Pierre Mercier or JP Barral have contributed significantly to include the visceral mechanics in the overall general mechanical economy of the body.

Visceral manipulations are used to improve the position, the circulation or the movement of the organs being especially effective in the treatment of the gastro-intestinal tract and together with the pelvic organs.

To highlight that visceral mechanics influences parietal and postural mechanics as well as that the visceras are emotional main points and are closely related to the psychic sphere.







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