Professor Korr admits that much work in this field remains to be done, but he states that when a condition of chronic facilitation exists in a spinal segment, 'We cannot say that this 24-hours-a-day state of alarm results in illness on a definite one-to-one basis. We can only say that these disturbed segments are relatively vulnerable, that the probability is higher. Whether or not it becomes clinically significant depends upon the person we are dealing with and all the circumstances of his life, past, present and future. Here is where other unfavourable circumstances in the patient's daily life may tip the balance; here is where an abnormal stress response will tend to find the earliest and most severe expression.' [2]

In addition to this line of research Professor Korr has done much work on the trophic function of nerves (concerning the nutrition of the tissues). Nerves not only conduct impulses but supply proteins and other substances to the tissues and organs with which they connect. These substances are essential for the maintenance and self-repair of the tissues, and they influence their total function. In considering the implications of this, Korr states that any factors that interfere with this aspect of nerve function may contribute towards disease. He says: Such factors could include disturbances (e.g. emotional stress) in descending impulse traffic from higher centers, impulse traffic in sensory pathways from various parts of the body, nutritional factors, drugs, toxicological agents, viral insults, changes in the chemical environment of the neurons and their axons (nerve cells) and, of course, the mechanical stresses and large forces exerted on and generated by the myofascio-skeletal tissues through which the nerves pass, and the accompanying chemical changes in these tissues. It seems likely that the efficacy of manipulative therapy may occur in part through alleviation of some of these detrimental factors. More recently it has been shown that the flow of material along nerves is a two-way traffic. The retrograde transport is seen as a means of communication, or feedback (literally) between the nerve cells and the cells they supply. Korr states: Any factor that causes derangement of transport mechanisms in the axon or that chronically alters the quality or quantity of the axonally transported substances, could cause the trophic influence to become detrimental. This alteration in turn would produce aberrations of structure, function and metabolism, thereby contributing to dysfunction and disease. Almost certainly to be included among these harmful factors is the deformation of nerves and roots, such as compression, stretching, angulation and torsion, that are known to occur all too commonly in the human being, and that are likely to disturb the intra-axonal [nerve cell process] transport mechanisms, intraneural [nerve cell] micro-circulation [circulation in the smallest blood vessels] and the blood-nerve barrier. Neural structures are especially vulnerable in their passage over highly mobile joints, through bony canals, intervertebral foramina [apertures], fascial layers [fibrous tissue beneath the skin] and tonically contracted muscles (for example, posterior rami [branches] of spinal nerves and spinal extensor [stretching] muscles.) Many of these biochemically induced deformations are, of course, subject to manipulative amelioration and correction. [3] As Paul Thomas D.O. states: This appears to be a part of the long sought answer to the question of exactly how the nerves influence the structures innervated, with respect to metabolism, development, differentiation, regeneration, and trophicity in general. The treatment of an organ through its innervation is an element in present manipulative therapy. The new information regarding neural function may lead to specific improvements in technique. [4] This knowledge, plus the segmental facilitation research of Korr and his associates, gives a scientific basis for the claims of osteopathic medicine; i.e. that dysfunction of the musculo-skeletal framework of the body can have profound effects on the health of the individual. Research Into Diagnostic Methods Research into the ability of osteopathic diagnostic methods to elicit accurately such dysfunction has also been carried out and evaluated. Between 1969 and 1972 over 6,000 patients admitted to Chicago Osteopathic Hospital were part of just such a clinical investigation. Visual and palpatory observations made by attending osteopathic physicians were recorded and analysed in relation to the health problems of the patients. The findings showed a clear link between the spinal area, diagnosed by the examining practitioner as being involved, and the corresponding diseased organs of the patient. The conclusion was: 'The somatic findings in over 6,000 cases of hospital patients support the osteopathic theory of viscero-somatic (internal organs and the body) relationships.' [5]