health care profession that emphasizes the relationship between the musculoskeletal structure and organ function. Osteopathic physicians develop skill in recognizing and correcting structural problems through manipulative therapy and other treatments.

Osteopathic medicine began in the United States in the 19th century as a reform movement against the then rather primitive armamentarium of drugs and surgical techniques. The founder, Andrew Taylor Still (Still, Andrew Taylor), developed a system of osteopathic medicine in reaction to the conditions and types of treatment that he observed while serving as an army physician during the American Civil War.

After failing to persuade various medical schools to incorporate his ideas into their teachings, Still established a new medical school in 1892 in Kirksville, Mo., where he began conferring the doctor of osteopathy degree (D.O.) upon those physicians who adhered to his concepts of medicine. Still's emphasis on treating the whole man has remained an ideal of the profession.

Osteopathic medicine still has its main base in the United States. Canadian osteopathic physicians have received their training in the United States, and osteopathic medicine in the British Isles is in part a form of postgraduate specialization by holders of the M.D. degree. Most osteopathic physicians who practice elsewhere in the world have also been trained in the United States.

General osteopathic hospitals (hospital) provide health care of all kinds, and specialty-oriented hospitals include maternity centres, proctology clinics, arthritis centres, emergency clinics, and alcoholism and drug-abuse centres. In the United States, osteopathic institutions are accredited by the American Osteopathic Association (AOA), and most are members of the American Osteopathic Hospital Association.

Professional education leading to the degree of doctor of osteopathy is similar to that for doctors of medicine. The four years of osteopathic medical education cover the basic sciences and clinical work, with emphasis on the importance of body mechanics and the relationship of body structure to function.

In Great Britain there are two schools of osteopathic medicine. Entrants to the British School of Osteopathy require only a secondary-school education, and their four-year course is limited to manipulative therapy and diagnosis. Upon graduation, their practice is limited to these areas. The London College of Osteopathy limits its entrants to those who possess the M.D. degree, and the 14-month course is meant to be a postgraduate training that stresses the musculoskeletal system and manipulative therapy. Graduates are accepted into the British system of socialized medicine and have unlimited practice rights.

Osteopathic physicians are licensed to practice medicine in all states of the United States and have the same professional rights and responsibilities as do holders of the M.D. degree in most states. In most cases, physicians of both schools of medical practice take their examinations before a medical licensing board composed of both doctors of medicine and doctors of osteopathy. In other countries, regulation of the practice of osteopathy varies greatly.

Osteopathic research studies include anatomy and function of nerve-and-muscle junctions, transmission of nervous impulses, somatic reflex functions, renal (kidney) growth and function, and blood-flow dynamics. There are also clinical studies of structural findings in hospitalized patients, the effects of manipulation under anesthesia for specific orthopedic problems, the effect of osteopathic manipulation on hypertension, and management of chronic obstructive lung disease by regular medical means, with and without osteopathic manipulation.