Viola Fryman adds these general thoughts on palpation.

Palpation cannot be learned by reading or listening; it can only be learned by palpation. But in order to learn let us develop a perceptive, exploratory palpation; let us look to find what is under our hands, rather than seek what the text advises us should be there. Every patient, on every visit, is a new territory to be explored. A history at best incomplete. Frequently patients forget, or do not choose, to remember traumatic events. But the human body bears a record of significant injuries for the physician to read if he understands the language of the tissues. The scars of disease also remain to distort and obstruct, if the disease was supressed rather than cured. These scars must be recognized and understood. Profound emotional shock, grief and anger also leave their imprints within. The sensitive, perceptive hands can find and change these effects with lasting benefit to the patient. This is the art and science of osteopathy.[3] Osteopathic diagnosis incorporates all that is useful and valid in standard medical diagnosis including the use of x-rays and other standard tests and procedures. These are all used as well as the unique and distinguishing measures and skills discussed above. This enables the osteopathic practitioner to read the signs that others might miss.

Knowledge of the many reflex pathways and activities in, and between, the body systems, is a further aid to accurate osteopathic diagnosis. A system which combines diagnosis and treatment is the use of what are known as neurolymphatic reflexes. These were first described by an osteopath. Dr. Frank Chapman, in the 1930's. These comprise areas of 'stringy', sensitive tissue, in precise areas of the body. When present they indicate dysfunction or pathology of associated areas or organs. Treatment of these areas, by pressure techniques, is a useful method of promoting recovery, as well as being a means of ascertaining the degree of severity of the problem. There are other reflex patterns in the body such as the so called 'trigger' points (myofascial triggers) which produce pain in predictable target areas when irritated. Via knowledge of these and other reflexes, osteopaths are able to assess the patient's symptoms and can often diagnose potential problems before they have shown themselves.

1. ‘Anatomic Basis of Osteopathic Concept’. Journal American Osteopathy Association, Vol 79, No. 12, page 759.
2. ‘Palpation', Academy of Applied Osteopathy Yearbook 1963, page 17.
3 ’Palpation', Academy of Applied Osteopathy Yearbook 1963, page 31.