Osteopaths utilize specialized soft-tissue techniques which bear a superficial resemblance to massage. Both deal with the soft tissues. The osteopath is either preparing the area for subsequent manipulation or dealing reflexly with problems distant from the area being treated. The U.K. trained osteopath might use a system developed in England known as neuro-muscular technique. In the U.S.A a similar deep soft tissue method was developed by the late Ida Rolf. Both these method have some similarities with the specialized German method of connective tissue massage (Bindesgewebsmassage) which uses deep finger and thumb strokes to achieve local and reflex effects Rolfing aims at releasing deep tissue contractions and thus encouraging postural and structural reintegration, and psychological 'release' from emotions which are tied into muscular stress patterns. Neuro-muscular technique, rolfing and connective tissue massage are all specialized soft tissue methods, bearing little in common with what is normally, thought of as massage.

Physiotherapy
In orthodox medicine the remedial gymnast and masseur of old has been replaced by the physiotherapist of today. This profession is an adjunct of the dominant medical system, and it incorporates a variety of modalities such as exercise, massage and manipulation. Traction and some forms of hydrotherapy also form part of the physiotherapist's methods. In other words anything that can usefully be employed in treating the physical body, to enhance its function, or to minimize its dysfunction especially as related to the muscles and joints, is incorporate' into physiotherapy. There are, of course, other rehabilitative aspects and therapeutic ones (such as encouraging normality after injury or surgery, and assisting in respiratory function in asthmatics.)

In the main, however, physiotherapists deal with the vast range of rheumatic diseases with the modalities outlined. Their use of manipulation tends to be confined to a limited range of specific techniques which are applied to the neck and low back areas. The techniques employed are usually direct action ones where joints are forced through a range of motion. Doctors of physical medicine and orthopaedic surgeons tend to limit their sphere of interest to the mechanics and pathology of the musculo-skeletal system. This is a large and vital area, but from the osteopathic viewpoint it is important, not only in itself, but because of the ramifications that dysfunction in any of its constituent parts may have on the overall economy of the body and on specific organs and functions.

As we shall see in the unfolding of the history and current practice of osteopathy, as important as manipulative methods and specialized osteopathic diagnostic methods are to the science of osteopathy, it has always been recognized that care of the 'whole' man requires the integration and use of all methods and measures which contribute to well-being. This was made clear in the charter of the first College of Osteopathy in 1892. The aim then was stated to be 'To establish a college of osteopathy, the design of which is to improve our present system of surgery, obstetrics and treatment of diseases generally, and to place the same on a more scientific and rational basis and to impart knowledge to the medical profession'. A reforming role was seen as being the essential part osteopathic medicine would play. The subsequent history and the success of the profession especially in the country of its birth, against extraordinary odds, is fascinating. Before we touch on this, however, a man of extraordinary vision deserves our attention; Andrew Taylor Still.