massage

massage broadly construed as therapy by touching, is one of the oldest and most widespread of medical practices. Although massage has been used to treat a number of bodily and mental illnesses, it has always been popular with the healthy to promote feelings of ‘well-being’. Massage is a common accompaniment to sexual activity, and attempts at ‘professionalization’ have suffered from massage's association with male and female prostitution. Other health care-related professions incorporate massage, including nursing, physical therapy, chiropractic, and osteopathy.

Some forms of therapeutic touching rely on what might be called a transfer of force or power from the operator to the patient. The Gospel reports that Jesus took a dead girl by the hand and revived her. At the same time a woman was healed of a twelve-year haemorrhage by touching Jesus' robe. He then caused two blind men to see by touching their eyes (Matthew 9: 18–31). During the Middle Ages and until the eighteenth century, the skin condition scrofula, or king's evil, was thought to be healed merely by the royal touch. Mesmerism in eighteenth-century France and magnetic therapy in nineteenth-century America both relied on the special power of the operator to stimulate the subject, often in a sensational public spectacle. From the early seventeenth century medicinal flogging was a popular form of therapy, especially for sexual difficulties and later for various types of mental illnesses.

Massage that would be recognized as such by readers of today had its origins in the Swedish court of Charles XIII, who opened the Central Institute of Gymnastics in Stockholm in 1813. Under the director, Pehr Henrik Ling (1776–1839), a system of ‘active massage’ or medical gymnastics known now as Swedish massage was developed. What distinguishes Swedish massage from other forms is the resistance the patient was expected to exert against the manipulation of the operator. Massage and exercise in Swedish therapy are therefore combined. Romantic interest in classical statuary seems to have stimulated this growing interest in physical culture and in an association of a sound body with morality. Nineteenth-century scientists also began to compile any number of measurements and statistics which allowed them to postulate an ‘ideal’ body type, making people exceedingly conscious of any deviation from it.

Passive massage, which is perhaps more popular, has an important place in the medical professions, especially in physical therapy and in nursing. By World War I, distinctions were being made between various forms of passive massage, including kneading, stroking, rubbing, and tapping, each with its own purposes and rules.

In general, passive medical massage was thought to improve the circulation of blood and lymph, to release waste material from the muscles, and to improve nutrition within the muscle itself. This was especially important for the polio victim, who could not exercise wasted muscles. Medical massage textbooks advised that the male or female operator be very physically fit and above all have a glowing good character, due to the intimate nature of the activity.

Nowadays most people do not think of massage as a medical activity supervised by doctors and nurses in a hospital, although in this context it is one of the techniques important in physiotherapy. Most massage takes place in the private commercial sphere of the marketplace and is seldom covered by health insurance unless part of physical therapy for an injury. Some commercial massage, Swedish or sexual for instance, are offered to patrons because it feels good, whether one is ill or not. More interesting are the sorts of passive massage that purport to treat various complaints outside the realm of traditional medical practice. Chiropractic and osteopathy are two medical disciplines involving bodily manipulation that have fought long and hard for respectability within the health care system. Osteopathy had its origins in the efforts of Andrew T. Still (1828–1917), who formulated a medical system in Kansas and Missouri, US, in the 1870s, based on his belief that disease was caused by ‘lesions’ that impaired the flow of blood and lymph. Osteopathic therapy consists of the removal of this lesion by manipulation, and not by surgery or drugs. It also insists on corrective hygiene, diet, and good mental and physical regimen. Osteopathy is widely recognized in the American Midwest and is also practised in Canada and in Europe.

Chiropractic was developed at the end of the nineteenth century in Davenport, Iowa, US, by a non-traditional healer, Daniel David Palmer, who began his career by using his ‘personal magnetism’ to cure by touch. Palmer theorized that many diseases could be treated by ‘freeing the nerve flow’ from blockage by spinal manipulation. Like osteopathy, chiropractic believes that the body possesses the innate power to heal itself, and that the operator helps restore balance and harmony by physical manipulations. Chiropractic has spread worldwide, especially to Japan. Like osteopathy it is a licensed and examined medical speciality.

Other forms of massage derive from an Oriental and Indian system of healing that comes ultimately from China. Shiatsu, or finger pressure, is a Japanese system of massage. Its theoretical basis is like that of acupuncture or acupressure: disease comes from an obstruction in the flow of ‘ki’ (chi) along the meridians of the body. The operator is instructed to gather information about the patient by touching, listening, looking, and asking questions. The patient must trust the operator because, unless that happens, important information and illnesses will be hidden and treatment will not be successful. The operator applies finger pressure to the patient for the purpose of freeing the flow of ki to restore health and prevent disease. Reflexology is similar to chiropractic in that it relies on the manipulation of one part of the body to restore balance and harmony in remote parts. The purpose of reflexology is to relieve ‘congestion’ and ‘tension’ all over the body by selective massage of the foot. Reflexologists claim their art has its origins in ancient India, China, and Egypt.

Commercial massage obviously meets the needs of large numbers of people who enjoy the experience, or who suffer from complaints not recognized by traditional scientific medical practice. The refusal by many massage practitioners to separate mental from physical well-being no doubt appeals to many clients. Such massage therapies seem to be following the development of other medical professions. In many countries they are licensed and board-certified.

Faye Getz

Bibliography

Bloch, M. (1973). The Royal Touch. Routledge, London.
Cook, H. J. (1993).
Physical Methods. In Companion encyclopedia of the history of medicine, (ed. W. F. Bynum and R. Porter). Routledge, London and New York.

See also chiropractic; osteopathy; physiotherapy.