Center for the Future of the Health Professions March 2025
Posted: March 13, 2025
The Center for the Future of the Health Professions, dedicated to providing policymakers and healthcare stakeholders with comprehensive data for effective planning, presents our third op-ed column for 2025, “Charles Darwin and A.T. Still, DO: An osteopathic approach to evolution and a new paradigm of science” by James F. Keane, DO. The paper presents an interesting synthesis of evolutionary theory and osteopathic philosophy.
The paper attempts to merge Dr. Still’s concepts about “life as matter in motion” with our understanding of genetics and evolution. The advancement of scientific understanding often occurs at the intersection of seemingly disparate fields, where established frameworks encounter novel perspectives. This paper explores the unique synthesis of Charles Darwin’s evolutionary theory and Dr. Still’s osteopathic philosophy – two paradigm-shifting approaches developed in the late 19th century. While Darwin’s theory of evolution through natural selection revolutionized our understanding of biological diversity and adaptation, Dr. Still’s osteopathic principles provided insights into the relationship between structure and function in living organisms. By examining the conceptual parallels between these frameworks through a modern scientific lens, we can develop a more comprehensive understanding of life processes from the molecular to the systemic level. This integration offers theoretical coherence and practical implications for future research in genetics, evolutionary biology, and therapeutic approaches. As we navigate the ever-expanding frontier of biological sciences, this unified perspective may contribute to a new paradigm that transcends traditional materialistic views and encompasses the full complexity of living systems.
Our guest author, Dr. Keane, is a board-certified internist and holistic medicine physician who regularly practices osteopathic manipulative medicine as the medical director of ATSU’s Osteopathic Medicine Center. After practicing in several Arizona-based clinics, both in- and outpatient, Dr. Keane joined A.T. Still University’s School of Osteopathic Medicine in Arizona’s faculty full-time in 2018. Born and raised in Chicago, Illinois, Dr. Keane has spent the last 25 years in Arizona.
Dr. Keane received a master’s degree in higher education from Arizona State University (ASU). Following his time at ASU, he served as an analyst at the Arizona State Senate and briefly as a lobbyist for Arizona’s cities and towns. After studying health and wellness informally for years, Dr. Keane left public policy to attend Midwestern University in Glendale, Arizona, and completed his internal medicine residency in Sierra Vista, Arizona.
For fun, Dr. Keane enjoys spending time with friends and family, hiking, cooking, meditating, and other hobbies.
Contributing authors to this article are Drs. Randy Danielsen, Mai-Ly Duong, Len Goldstein, and Marisa Hastie. Amanda Weaver also contributed to the article.
We welcome your feedback and comments on this month’s digest at cfhp@atsu.edu.
Randy Danielsen, PhD., DHL(h), PA-C Emeritus, DFAAPA
Professor & Director
The Center for the Future of the Health Professions
A.T. Still University
Charles Darwin and A.T. Still, DO: An osteopathic approach to evolution and a new paradigm of science
Introduction – Paradigm shifts in science
The insights of truly original visionaries generate new paradigms of human thought and awareness of reality. For instance, Nicolaus Copernicus’ observations that Earth revolved around the Sun led away from the concept that humans and the Earth were the center of the universe, thus ending the anthropocentric paradigm. While the idea that Earth is a round sphere existed since ancient Greece with Eratosthenes of Cyrene, Galileo’s observations provided empirical and reproducible support for humans living on a spherical planet orbiting the Sun. Sir Isaac Newton’s findings began a new paradigm of understanding that the solar system and Universe were subject to non-material forces such as gravity, invisible to the eye but recognizable by the movement generated in objects. More recently, Charles Darwin began a new paradigm in the biological or life sciences by describing heritable physical traits that evolved or changed over time and which influenced survival, otherwise known as natural selection. Just as Galileo and Newton supported Copernicus’ theories, so did Gregor Mendel and James Watson; Francis Crick and Benjamin Franklin also supported and expanded upon Darwin’s theory of evolution.
Since the split between church and science in Europe hundreds of years ago, science has focused on material objects composed of matter and atoms. At the time, to overcome beliefs that did not accurately portray reality, science considered matter the only “real” thing. In a sense, science created a “materialistic” or “physical” paradigm that focused on atoms and relegated anything non-material as not being real and belonging more to the areas of religion, spirituality, and mysticism than science. However, recent astronomical observations suggest that only five percent of the energy released by the Big Bang became atoms and matter. Could some of the 95% of what is in the Universe, which does not matter, be involved in life forms?
About 10 years after Mendel presented his findings on pea plant experiments, an American physician and philosopher, Andrew Taylor Still, DO, experienced insight regarding organisms’ material and non-material components and still related that “life” put matter, or atoms, from the Earth’s environment in motion to form an organism’s body. Also, Dr. Still realized atoms do not change when aggregated to form an organism’s body, but rather the health or function of an organism depends on if the atoms forming its body are aggregated in a functional structure. As the body is an aggregation of inert matter incapable of forming consciousness, Dr. Still proposed the concepts of “spirit” and “mind” as non-material components of a human being. In a sense, Dr. Still’s insights led to a new paradigm of biological sciences that focuses not only on the matter forming an organism’s body but also on what within life forms may not be material and may not be made of atoms. By applying the concepts described in osteopathic philosophy as described by Dr. Still to the field of genetics and microbiology, a novel conceptualization of existing knowledge can occur.
Darwin, evolution, and modern genetics
In 1859, Charles Darwin wrote “On the Origin of Species,” where he described the process of evolution through natural selection. Under natural selection, organisms that have developed a new anatomical or physiological feature, which can be passed on to subsequent generations and provides an advantage over other organisms, are more likely to survive and reproduce. Through this process based on ongoing physical changes of organisms, simple life forms such as a bacterium can evolve into multicellular organisms of almost unlimited shapes and functions. Darwin wrote, “From so simple a beginning endless forms most beautiful and most wonderful have been and are being evolved.”1 However, much about evolution’s process remains to be explored.
In 1865, Mendel outlined the principles of genetics regarding inheritable traits that could influence natural selection, which are passed from generation to generation of organisms, through his study of the common pea plant.2 Other insights into inheritance continued to be developed until 1953, when a major breakthrough occurred. Watson and Crick (as well as Franklin) discovered that DNA was a double helix of aggregated nucleotides, thus providing the mechanism for genetics, mutations, and evolution.3 DNA is a molecule that aggregates atoms with information encoded into its structure. When translation and transcription processes occur, the information within the DNA’s structure is used to aggregate another molecule from other atoms, usually a protein or a messenger RNA (mRNA) fragment that forms part of an organism’s body.
Mutations that alter an organism’s body and influence natural selection involve changes in the structure of its DNA, which can occur in various ways and lead to modifications in the structure and function of the molecules that form the organism’s body. If the new molecule arising from a DNA mutation improves the organism’s chances of survival within natural selection, a new organism has evolved. Evolution is the process of aggregating the same atomic building blocks into new structures that have new functions within organisms’ bodies.
Dr. Still and osteopathic philosophy
In the late 1860s to early 1870s, following a great personal tragedy, and after much exploration and introspection, Dr. Still experienced a new, radical insight into life, health, pathology, and healing. Dr. Still named this new insight “osteopathic philosophy,” or simply “osteopathy.” With the successful integration of these concepts into clinical practice, on June 22nd, 1874, Dr. Still went public with his insights and “… flung to the breeze the banner of Osteopathy.”4 Almost twenty years later, in 1892, Dr. Still founded the American School of Osteopathy (ASO), known today as A.T. Still University, to train students in the application of osteopathic philosophy in medicine. Even more fundamentally, the ASO was formed to share Dr. Still’s understanding of osteopathy with the broader world.
To describe his insight into osteopathic philosophy, Dr. Still wrote that “… life is matter in motion, “4 and,
When all parts of the human body are in line, we have health. When they are not, the effect is disease. When the parts are readjusted, disease gives way to health. The work of the osteopath is to adjust the body from abnormal to normal, then the abnormal conditions give way to normal, and health is the result of the normal condition.5
Translating Dr. Stills writing into modern terminology
“Life is matter in motion” could be translated into modern scientific language as “life’s homeostatic processes exert a force on inert atoms and molecules within Earth’s environment to put them in motion to assemble or aggregate an organism.”
“Matter” can be substituted with “atoms,” leading to “… life is atoms in motion.” Per the laws of physics, atoms do not move by themselves; they are inert and only move as the result of an external force, leading to “… life expresses a force on atoms to put them in motion.” As organisms’ bodies do not create matter but are made up of atoms absorbed from the Earth’s environment, the quote can be further translated: “… life expresses a force on environmental atoms to put them in motion to aggregate an organism’s body.” When an organism dies, the force of life is no longer present and the atoms aggregated to form an organism’s body lose aggregated structure, fall apart, and return to the environment. Throughout an organism’s life span, the matter of which its body is composed does not change, is neither created nor destroyed, but put into motion by the force of life to serve as building blocks of an organism’s body.
That all organisms are made up of atoms is widely accepted, but science has missed the broader picture that this understanding offers. Organisms do not make or alter the atoms that form their bodies or their DNA; instead, all homeostatic processes in life forms exert a force on environmental matter to assemble and maintain their body. Atoms within an organism come from and are the same as similar atoms in the environment. In other words, atoms that form DNA do not become “alive” and are billions of years old. An atom of carbon is the same whether within the molecular structure of carbon dioxide circulating in the atmosphere, the molecular structure of a diamond, or the molecular structure of DNA in a living human being. In a sense, atoms are building blocks that make up an organism’s body, like toy blocks that are brought together to make a larger structure. Unique molecular structures that are formed through life’s homeostatic processes and the process of evolution are the only differences that organic matter has from inorganic matter.
A translation of the second Dr. Still quotation from Research and Practice could read, “When the aggregated atoms forming an organism’s body are maintained in a functional structure by life’s homeostatic processes, the organism is fully functional, or healthy; when the organism’s aggregated atoms are not maintained in a functional structure, a loss of function occurs and the organism is ill or suffering from pathology; and healing results when the aggregated atoms forming the organism’s body have been restored to a functional structure leading to a return of normal function, or health.” The “parts of the human body” that must be “in line” to have health are the inert atoms that have been aggregated by life to form the body. If those atoms have been aggregated into a functional structure to form the body from the molecular to the gross anatomical level, the body will usually work, which is healthy. If the atoms aggregated to form the body are not “in line” and are not aggregated in a functional structure, the result is loss of function or pathology. When the atoms that have been aggregated together to form a body have been restored from a dysfunctional to a functional structure, when they have been put back “in line,” the result is a return of function or healing. All forms of diagnosis evaluate the aggregated material structure of the body, and all forms of healing restore functional aggregated structure to the atoms forming the body.
As described by Dr. Still, osteopathic philosophy can be fully applied to the DNA within organisms, which is made up of billion-year-old atoms from the Earth’s environment that have been temporarily aggregated together in a specific structure with a specific function. A simplification of the metacognitive process supported by osteopathic philosophy applied to DNA and the process of evolution could be expressed as:
- Life: How are atoms aggregated to form DNA and encode specific information? What embryological and homeostatic processes are involved?
- Health: How is the normal aggregated structure of DNA related to its normal function?
- Pathology: How can losses of function be linked to a loss of aggregated material structure, and vice versa? How can the structure and function of DNA be evaluated to identify morbidity or the absence of normal structure and function? Has an external force disrupted aggregated structure within the body (i.e., a cosmic ray striking DNA)? Could a loss of structure be related to disrupted homeostasis (i.e., a problem with accurate DNA synthesis due to a B12 deficiency)?
- Disease: How can the functional aggregated structure of DNA be restored?
Integrating evolution and osteopathic philosophy
As described by Dr. Still, osteopathic philosophy does not create information or new facts, unlike the work of Mendel or Franklin. Instead, osteopathic philosophy is an inductive framework in which existing knowledge and existing facts can be arranged. Inductively grouping information does not create new information but instead allows a greater perception of those facts, leading to the creative formation of new theories that can be used to identify more knowledge or make predictions in new situations.6 In this sense, while first described in the late 1800s by Dr. Still, osteopathic philosophy can assist the exploration and discovery within genetics and molecular biology.
Life: Matter put in motion to form an organism’s body, including DNA
Dr. Still’s concept that life moves matter to make a body can be applied to genetics and evolution by realizing DNA is formed of inert matter from Earth’s environment. In a sense, DNA synthesis results from putting matter or atoms in motion to form molecular building blocks arranged in specific structures containing information. DNA is made up of nucleotides, molecular building blocks comprising four constituent bases: adenine, thymine, guanine, and cytosine. Just as every other part of an organism’s body, nucleotides and their bases are aggregations of atoms from Earth’s environment, the structures of which differ by a small number of atoms.7 The atoms forming DNA and all other body parts came from Earth’s environment, where they have been and will continue to be for billions of years. Atoms do not change when aggregated into DNA or any other body part; they remain inert the entire time.
Working backward, following the trail of how atoms are aggregated into a molecular structure that holds information (e.g., DNA), which is used to aggregate other atoms into other molecular forms, such as proteins and mRNA, which are used to form an organism’s body, several insights emerge.
In a sense, DNA directs the formation of the cells and systems (themselves aggregations of matter) that assemble other atoms obtained from the environment to form other parts of the body. All these structures primarily comprise the same atoms, such as carbon, nitrogen, and oxygen. For example, DNA produces molecules that form osteoblasts, the cells that build bone. Once formed, osteoblasts work with other atoms, such as calcium, that are absorbed from the environment to aggregate bone.8
DNA synthesis or replication must assemble a structurally intact copy of the original strand of DNA to preserve the information contained within on which the formation of the organism’s body is based.9 DNA formation or synthesis occurs when an existing strand is copied through the activity of multiple enzymes, most notably DNA polymerase. Interestingly, DNA polymerase is a protein produced by transcribing and translating DNA. DNA has instructions for copying itself, which another enzyme must read. Also produced from DNA is RNA polymerase, which will produce DNA polymerase to begin making copies of DNA. Currently, the origins of how atoms aggregate together to form the RNA polymerase enzyme, or the DNA sequence containing the gene for that enzyme, are unclear. However, they are the center of much research.10
Current scientific theories suggest that random changes in the molecular structure of matter led to the formation of RNA, or an RNA-precursor molecule, that then led to DNA formation. Essentially, random forces on Earth moved atoms to eventually produce a molecule with a capability that exceeded the atoms of which it was aggregated in that it could make copies of itself. To make copies of itself, the molecule had to exert a force on other atoms in the environment and perform work to change their molecular structure.11
As described by Dr. Still, osteopathic philosophy suggests another possible mechanism for forming the first molecules used to aggregate an organism’s body. He wrote that “… life is matter in motion.” Perhaps “life” is distinct from the matter it puts into motion. In other words, “life” exists but is not material or made of atoms. While this notion sounds far-fetched, almost religious or spiritual, current science supports that something not made of atoms may be involved in aggregating atoms that form an organism’s body. Recent data from astrophysics suggests that of all the energy released during the Big Bang, the beginning of our Universe, approximately 5% became atoms, became matter.12 In other words, 95% of what exists in the Universe is non-material, not made up of atoms. This part of the Universe is referred to as “dark matter,” but a more specific description would be “not-atoms.” The tenets of osteopathic medicine state, “The body is a unit; the person is a unit of body, mind, and spirit.”13 As described in detail by science, the body is an aggregation of atoms of matter within the Earth’s environment. “Spirit” or “life” then may refer to any forces within an organism that are not material and are not generated by atoms, but that move matter and may be of the 95% of the Big Bang’s energy that did not become atoms.
Anthropocentrism, or the belief that humans are the most important entities in the universe, led to human-centric theories that placed Earth at the center of the universe—a notion later disproven by Copernicus and Galileo.14 Perhaps our current paradigm of biological sciences could be described as “material-centric,” based on the concept that matter is the center of the Universe. Dr. Still’s insights suggest that something other than matter puts matter into motion to produce an organism’s body and may lead biological sciences to expand the focus of study beyond matter, beyond atoms. By moving beyond a material-centric universe and integrating the 95% of reality that is not matter, biological sciences may open a new paradigm of describing non-material components of organisms.
Health: Normal function due to normal structure
DNA’s function is based on its structure, which contains information used to assemble or aggregate atoms into proteins and other molecules, such as mRNA, that form an organism’s body. Proteins are formed by a two-step process: transcription and translation. The transcription process involves multiple enzymes reading a section of DNA and producing mRNA by aggregating atoms within a specific structure. Transcription is followed by translation, where ribosomes read the mRNA’s molecular structure to assemble proteins by aggregating amino acids, molecules formed of atoms of matter.15 These proteins are used to form an organism’s body, and each has specific functions.
Current methods to evaluate DNA’s function ultimately evaluate DNA’s aggregated structure. “High-resolution molecular cytogenetic analysis can now detect deletions or duplications of DNA of a few hundred thousand nucleotides,” which really is an evaluation of DNA structure, determining if the atoms have been aggregated in a specific structure.16 Dr. Still’s observation that “… when the body is in line, the result is health” accurately applies to DNA.
Pathology: Loss of function due to loss of structure
DNA loses function when its aggregated structure is lost when it suffers structural damage, almost like a fractured bone. Damage to DNA’s structure can occur in various ways: ionizing radiation (IR), reactive oxygen species (ROS), cosmic rays, errors in DNA replication, micronutrient deficiencies, and others. Galactic cosmic rays (GCRs) are composed of high-energy particles that can collide with and damage the structure of DNA. “When IR hits the DNA molecule, single-strand breaks (SSBs) and double-strand breaks (DSBs) arise.”17 Deficiencies in vitamins such as B12, B6, C, E, folate, or niacin can lead to similar SSBs or DSBs, a widespread public health concern. Up to 20% of the population may have such deficiencies. “A level of folate deficiency causing chromosome breaks occurred in approximately 10% of the population in the United States, and in a much higher percentage of the poor.”18
When the structure of a coding section of DNA is damaged, the information that guides transcription and translation in aggregating a protein is also damaged. Damaged DNA produces end products, such as proteins, that are not structured typically. As a result, those proteins will not function correctly, leading to a loss of function or disease within the organism.19
As described by Dr. Still, osteopathic philosophy still supports this concept, suggesting that when DNA is not “in line” and is not aggregated within a functional structure, it no longer functions normally; it is diseased.
Healing: Putting DNA back “in line”
Damage to the structure of a DNA molecule is repaired through the activity of several enzymes, including DNA polymerase. Healing DNA involves restoring the original structure of the molecule so that it usually produces structured and functional proteins when transcribed and translated.20
Multiple pathways for DNA repair exist. An example is mammalian O6-methylguanine-DNA methyltransferase (MGMT). MGMT works by absorbing damaged molecular components from the DNA to reverse structural damage.21 As vitamin B12 deficiency can result in structural damage to DNA, providing vitamin B12 can result in DNA structural repair. Beyond antioxidant properties that protect DNA from ROS, the resolution of a B12 deficiency restores the function of enzymes such as methionine synthase and methylmalonyl-CoA mutase, reducing genetic instability.22
While the science behind restoring the structure of DNA is still in its infancy, for instance, the use of CRISPR-Cas9 gene editing,23 Dr. Still’s guidance accurately describes future research efforts as ways to put DNA back “in line.”
Evolution: A loss of DNA structure leading to a new molecule with a new function
Mutations result from a loss of structure in the organism’s DNA, which is not fully restored or healed.24 While most mutations have little effect on an organism’s health and ability to function normally, some involve a loss of function, such as those found in sickle cell anemia.25 However, if the structural damage to DNA results in the transcription and translation of a new protein with a new function or a gain of function, an organism may improve its ability to survive the process of natural selection.26 In this sense, evolution is a loss of structure in DNA that does not result in a loss of function but, instead, a gain of function based on the aggregation of a novel protein, a new structure of matter. To paraphrase Dr. Still, evolution is the process of life putting matter in line in a new way with a new function.
Osteopathic philosophy points to a future where humans can aggregate new DNA molecules, producing new proteins or other molecules with potentially new functions in organisms. In a sense, science can speed up the process of evolution without waiting for random mutations to occur. Such a concept is supported by recent advances in computer software to predict protein structures from sequences of amino acids.27
Conclusion
Mutations in DNA lead to novel structures of matter within organisms’ bodies, new proteins, and other molecules, potentially with new functions. An organism that develops a new structure of matter with a new function, in a sense, has become a new species; it is no longer the organism it once was. The evolutionary process of natural selection is based on the interaction between organisms with these newly evolved molecules and the new advantages (or disadvantages) they bring to the organism within its environment. Based on natural selection, organisms with mutated, more functional structures of matter that form their bodies can better survive and reproduce. Evolution, as first described by Darwin and expanded upon by later scientists, is the progression of this process based on new molecular structures resulting from mutations in DNA that have new functions.
Dr. Still’s insight, which he labeled “osteopathic philosophy,” does not create new facts. Instead, osteopathy inductively groups facts together to form a new perspective from which new understandings and new creative theories can emerge. Applying osteopathy to genetics and microbiology will likely produce ongoing insights and discoveries.
Osteopathic philosophy can help organize the explosion of new information related to genetics, whether diagnosing new mutations or guiding gene therapy. Any genetic disorder results from DNA not being “in line,” and ideally, the treatment will be to put DNA back “in line.” Regardless of how much detail the expansion of scientific knowledge occurs, the organizing conceptual understanding provided by osteopathy remains accurate and applicable.
Osteopathy also points to new, creative approaches to genetics and molecular biology. By using an “osteopathic typewriter,” future scientists could assemble new genes by linking nucleotides together in a new way and then translating and transcribing those genes to see what new molecules are produced. While current technologies such as CRISPR are revolutionary, they depend on already-evolved genes. Future healing based on osteopathic principles may involve forming new genes to produce new molecules with new functions in life forms. Emerging technologies based on osteopathic philosophy will generate an accelerated rate of evolution, not guided by chance but by human experiment. They will create a critical need for appropriate ethical and moral guidelines.
Finally, applying osteopathic philosophy to genetics and microbiology may establish a new paradigm in biological sciences that addresses what is not made of matter within organisms. Could the evolving material components within life forms allow consciousness greater interaction with the material plane, such as what happened with the sense of sight evolved? Just as with past paradigm shifts within science, this aspect of osteopathy, of Dr. Still’s insight, seems the most absurd but likely will bear the most fruit over time.
References
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