Manipulation as a treatment modality dates at least to the time of Hippocrates, (Schiotz and Cyriax, 1975). It has continued to be used intermittantly thereaft- er. In the late nineteenth century manipulation became a fundamental part of a new school of medicine founded by Andrew Taylor Still, M. D. (Northup, 1966). Osteopathy was presented to the medical world in 1874, and the first for- mal education began in 1892 in Kirksville, Missouri. Another school of prac- tice, chiropractic, was founded in 1896 by D. D. Palmer in Davenport, Iowa (Janse, 1975). While both of these new professions utilized structural diagnosis and manipulative therapy, osteopathic medicine sought to incorporate these di- agnostic and therapeutic tools within the practice of medicine and surgery, while chiropractic limited its practice to spinal analysis and adjustment. Orthodox medicine has also had its advocates for the use of manipulation (Mennell, James, 1948; Mennell, John, 1964; Cyriax, 1978; Maigne, 1972; Bourdillon, 1973). In the mid 20th century formalized organizations of individ- uals interested in manipulation were formed throughout the world. The Inter- national Federation of Manual Medicine, a confederation of associations of manual medicine from 20 countries, holds an international congress every three years. The North American Academy of Manipulative Medicine was founded in the early 1960s and sponsors conferences and conventions through- out the United States and Canada.