At the time Dr Still was living in Kirksville, Missouri, and his fame spread rapidly, and patients came to him from all over America. He found that by careful palpation, i.,e. examination by feeling the surface of the body, he could ascertain abnormalities, and by careful manipulation he could often restore normal function. In many cases he found that he was able to achieve beneficial results, where previously he had failed. He records success with cases of pneumonia, asthma and many acute and chronic ailments. Osteopathy, to Still, meant diagnosis followed by specific manual techniques applied spontaneously until he felt the desired changes in the tissues or joints on which he was working. He did not apply manipulation as a remedy for symptoms as such, but regarded himself as a mechanic of the living body, restoring or encouraging its natural powers of recovery.

The case of the child with dysentery illustrates how the idea evolved. Starting with the idea of moving heat from one part of the body to another he used his hands on the child's spine, felt abnormalities and proceeded to normalize these, with good effect. By trial and error he found that similar abnormal structural changes existed in many conditions and from these simple beginnings grew a new science.

The facts have not changed, such abnormalities are still to be found in most spines. We do, however, have more of an idea as to what the physiological and pathological implications of these areas are. They used to be called osteopathic lesions, and a great deal of vitriolic, not to say hysterical, attacks on the very idea of their existence, have been made by medical writers. The current osteopathic terminology labels these 'lesions' as 'areas of somatic dysfunction', and later we shall examine in more detail their significance.

Still's gifts as a skilled manipulator and healer are well documented. There was a celebrated case in which he reduced a dislocated elbow in minutes after four physicians had failed, even with the patient under anaesthesia. His contribution to the healing art was to offer an alternative to the heavy drugging of orthodox medicine of that time. He also conceived the basic theories of his new approach and developed and originated the manipulative skills without any outside aid. A man of brilliance and dedication, he stubbornly persisted in his work, despite enormous opposition from the medical establishment.

In considering his contribution, it is as well to realize that medical knowledge as we know it today was in its infancy. Antiseptic surgery was only just being introduced by Lister against conservative opposition. It was another twenty years before radiography was introduced, and the germ theory of Pasteur had only been established some ten years previously. It was in this dark age that Still worked out a practical system of structural therapeutics that has never been invalidated by later discoveries. Still emphasized the importance of the musculoskeletal system as a major factor in disease processes; he recognized the body structure as an important source of derangement. It was therefore also a major avenue for the application of therapy designed to assist natural defences and to repair and restore physiological adaptive functions. The result of this view is to distinguish the patient from his ailment and to recognize finally that only by understanding the attributes of health can the disease process be studied and corrected.