Text-Book of Osteopathy
American College of Mechano-Therapy
All cases should be carefully examined. Of all the methods
used in arriving at a diagnosis, palpation or the use of the hand
is the most important one. By palpation the Osteopath usually determines
a dislocated bone, a contracted muscle or a tightening of a tendon
or cartilage. The patient's clothing should be arranged so as to allow
free access to the spine and thorax. The patient should be requested
to relax all tissues as much as possible and to offer no resistance
unless asked to do so. To intelligently examine a spine, the operator
should be thoroughly familiar with the outlines of the back. The normal
spine is divided into four curves, named from above downward: The
cervical curve, concave backward; dorsal curve, concave, forward;
lumbar curve, concavity backward; pelvic curve, concave forward.
Have the patient sit erect and stand behind him.
Note the curves to see if they are normal or not, and also any inequalities
on either side of the neck. Examine the glands of the neck for any
Place the patient on the back and relax all muscles.
Place one hand over the forehead and the other over the muscles in
the back of the neck. Manipulate the neck muscles while rotating the
head. Examine the tissues just beneath the skull, and the vertebrae
on both sides of the neck. By allowing the fingers to move down the
median line at the back of the neck, the spinous processes, can be
felt. By rotating the head and pressing the fingers along the transverse
processes, anterior, posterior and lateral deviations may be discovered.
Have the patient lean forward, while sitting, and
place his hands on his knees. Examine each vertebra carefully to determine
any dislocation or subluxation.
Examine the chest and abdomen and palpate the various
organs to detect any variations from the normal.