The History of Massage as Therapy

Touch has been an essential ingredient in the health of man from the beginning of time. Some of the earliest references to touch can be found in manuscripts as far back in history as 3000 B.C. There are even hieroglyphics in Egyptian tombs that illustrate the use of touch as a form of communication and healing. If we look at the animals around us on this planet we can see the most basic tactile instinct. Even the process of domesticating animals is to accustom them to human touch. Many of us today identify our relationships by types of touch. What is acceptable and what is not acceptable. In many scientific experiments, when animals were deprived of tactile experience, they would become unhealthy, susceptible to disease, and with a marked change in attitude. In the study of the care of premature infants, those that received touch became healthier, developed more rapidly and were generally happier babies. So when might the importance of touch have been realized? One of our most basic biological instincts is to respond to pain. Each time we sustain an injury, it is an immediate reaction to touch the area, either compressing or rubbing the area to reduce pain. If you watch animals, they do the same. When an animal is wounded, other animals will gather to lick its wounds, or even to rub the area. Much of the earliest recorded references to touch are in the form of anointing wounds.

Much archaeological investigation has been able to piece together the daily life of early man. He used the elements of nature around him to make his life more comfortable and assured. Heat and cold were basic perceptions which led man to caves, the use of animal skins for warmth and the application of water or mud. When a method led to a positive reaction, then it would be incorporated as part of acceptable knowledge. Because our response to pain is much more immediate than any other reaction we have, it is logical to assume that the methods to reduce pain would be most widely circulated during this time. The instinct of the animal to utilize touch in treating a wound would be one of the first instincts of man as well.

Then as the human brain stores the successful responses to treatment, it will search these memories each time a similar situation is encountered. This is the process of evoluation and learning that early man experienced. The Neolithic period (10,000 - 7,000 B.C.) was a time when humans changed from food gathering to food producing. This made it possible for man to begin to cultivate the very plants he had found to be most useful in treating illness and injury. It also made it more natural for each tribe to have their own healer who would reside on the land and take care of the people who came to him for help. The application of herbs with the nads and the beginning of traces of massage were again, the most basic response of these early healers.

But during this time, much of the success of these treatments were given to religious belief structure. Thus early medical treatment and religious ritual were inseparable. This made the success of each method based on the whim of a deity, instead of on the touch and the healing properties of the herbs. But is did promote the development of massage as a medical treatment form. And the most compelling evidence of this theory of early man’s development is that many disparate cultures established the same principles of medical treatment, even though they had no contact with eachother. Natives of the Sandwich Islands, the Maoris of New Zealand and the Tonga Island people all used massage, as did the Aztecs, the Egyptians and the Chinese.

Over time, healers became divided into specialties. Among the Aztecs (1000 A.D.) healers known as the Tictl combined herbs with external manipulations in treatment. Egyptians had many different levels of healers, some of which utilized massage treatments, herbal preparations and even surgery in treating illnesses and injuries. Wall paintings found in a physicians’ tomb in the Valley of the Kings seem to show an early practice of something similar to massage, dated around 2330 B.C. In China , massage was found described primarily in the medical writings of three important emperors. These are the earliest writings that refer to massage principles that we have:

* Fu Fsi (c. 2900 B.C.) originated the pa Kua, a symbol of yin and yang lines. This led to diagnosis and treatment based on balances in the body, an ancestor of the idea of structural integration in massage.

* Sheen Nung, the Red Emperor (Huang Ti) compiled the first medical herbal, the Pen-Tsao (c. 2800 B.C.). He is said to have drawn up the first charts on Acupuncture, but it is believed to be a much older practice in actuality. Wooden rollers were used to massage the abdomen for constipation, for instance.

* Yu Hsiung (c. 2600 B.C.) the Yellow Emperor (Huang Ti) wrote a great gathering of medical knowledge, the Nei Ching (Canon of Classical Medecine). This work has been translated for many centuries, most notably in the San-Tsai-You-Hoei, which was a Japanese book in the 16 th century, which provided the beginnings of Shiatsu knowledge.

Many of the Chinese writings were in the development of physical therapy by imitating the natural movements of animals. Current understandings of tapotement and petrissage were combined with this ingenious system of physical therapy. Writings during the Chou dynasty also mention the specialization of medical practices, and massage is listed as one such specialty.

In the year 3000 B.C., Bong Fau of Tao-Tse wrote a book on the beginnings of this system of Chinese exercises and movements, pointing out their usefulness in conjunction with massage techniques. It is this book which was later translated into French and may have been the first way in which Chinese massage was brought to the awareness of the Western mind. For this reason, it is the French terminology which continues in modern Swedish massage today.

By the sixth century, Chinese medecine had spread to Korea and it was through this medium that the Chinese medical philosophy was infused into Japan . After a severe epidemic struck Japan , many Korean physicians were summoned to utilize their skills in treating the infected Japanese people. The methods they used were Chinese and became part of Japanese medical knowledge from this point onward. But the Chinese were a closed culture and because of that, much of their early knowledge is lost today. They also declined to advance new techniques and ideas that were developed by their people. Much of this was due to the reverence of the Emperors, each new emperor requiring the dismissal of all knowledgable people of the previous reign, and distillation of all intellectual advances made during the previous reign. An astonishing example of this is found in Daniel J. Boostin’s book "The Discoverers". During the early 1600’s a Jesuit missionary group visited Beijing, bringing Italian clocks with them. The emperor Wan Li was amazed by the workings of the clocks; however 500 years before, a servant of the emperor named Su Sung had built a very precise astronomical clock, but when the new emperor came to power in 1094, the work of Su Sung was abandoned, since everything of the previous emperor’s reign was believed to be incorrect in design.

The Greek culture was also an advanced society in the realm of medical knowledge. The writings of many medical practitioners such as Herodicus in the fifth century B.C. discussed the use of massage with herbs and oils to heal injuries, and as an adjunct to surgery. Hippocrates was the pupil of Herodicus, and is known as the father of medicine today (The Hippocratic Oath). He lived from 460-370 B.C. and is most known for The Hippocratic Collection, which actually included writings by other physicians from Cos, where Hippocrates was an instructor. In these writings he used the word "anatripsis" which referred to the rubbing of an extremity upward. He documented the use of massage in the treatment of sprains, constipation and fractures. Other Greek physicians such as Celsus and Galen, the physician to Emperor Marcus Aurelius, referred to massage in their writings. Galen even wrote texts relating anatripsis to the discovery he had made of the existence of the arteries and veins and their use as a pathway for blood. Other physicians prescribed physical manipulations similar to tapotement for such disorders as tetanus, impotence and rheumatoid arthritis.

Greece had a highly developed set of trade routes through military conquest, especially with the people of Egypt and the Middle East , even long before Hippocrates. These routes extended into Africa, India and even beyond to the lands of China . This was especially true of the islands in the Aegean Sea . In fact, the Greek word for massage refers to kneading by the hands, which actually stems from the Arabic word "mass" meaning to press softly. Many Arabic texts were translated into Greek during this period by such well-known Arab practitioners as Avicenna. There is even a common theme from the Chinese through the Arab and into the Greek culture; one of balance in the body. Hippocrates called it "Vix Medicatrix Naturae" or nature’s life force, the Indians referred to it as prana. The Chinese called it Chi. Even in the Homeric writings, there is reference to "thymos". Aristotle based much of his medical writings and philosophy around the belief that health was a harmony of the body, whereas disease was really dis-ease, a disturbance of the body’s harmony. Pythagorus mentioned the harmony of the body through musical tones and related the body’s dysfunction to mathematical distortion.

In each culture, there is the acknowledgement that there is more to the body than meets the eye. And the use of touch was one way from the beginning of time to restore or destroy this harmony. Because of this belief, few pharmacological approaches were used in these cultures so as not to interfere with the course of nature in the healing process. But massage was viewed as an essential part of medical treatment.

In the Dark Ages, the Hindu culture flourished, which culminated in the writing of the Ayurveda. This was a compendium of all known medical knowledge combined with the popular and time-honored treatments of the body and spirit. Also Islamic science was at its peak, during which time many treatises on medecine, surgery and herbology were written. Much of this knowledge was taken from Chinese and even Egyptian sources. Avicenna was the most prominent Arab physician, known for his "Cannon of Medicine". He mentioned all known aspects of health and medical care. His writings were known throughout the Mediterranean cultures, and considered the basis of most medical care.

But one common attribute of these cultures prevented the Western world from benefiting from this extensive knowledge for many centuries. The word pagan. It was during this time that the beginnings of Christianity were extending beyond the boundaries of the Mediterranean , coming into contact with many various religious philosophies. As it grew, so did the idea of religious governance, and with it religious intolerance. Instead of absorbing the natural culture, Christianity destroyed the natural order in favor of its own concept of reality. With this destruction went everything that illustrated antithetical beliefs, including medical knowledge and massage. Manual manipulation and the concept of touch became associated with sexual attitudes or the spreading of disease. Since medical care was very limited, only the desperately ill would seek out medical care, leading to the belief that medical care had little benefit, since most of its patients eventually died. Only the Coptic Christians in the Nile basin maintained the early writings in conjunction with the Ascetic practices of the early Christians.

It was not until the 14 th century that Europe began to regain much of what it had lost. The church has been for centuries, absorbing the spoils of the Crusades. Monasteries were the repositories of the remainder of the Arab libraries, since many of the young nobility that had tyraveled on the campaigns were amazed by the degree of development that they found in the Fertile Crescent . Monasteries had been burdened with the arduous task of translating and transcribing texts that were brought back in the Crusades. In his book "The Name of the Rose", Umberto Eco illustrates the purpose of the monasteries as religious purification centers for the knowledge of the Arab civilization. Medical texts by Avicenna were purged of religious references and then hoarded in large libraries behind the Monastery walls. During the battle between the Church and the nobility, many monasteries were sacked for gold and money. In this way, the texts behind their walls were taken in by the nobility and utilized to increase their share in the power structure of the Middle Ages. Medical knowledge became more widely available, and in the early 14 th century, Guy de Chauleac published one of the most important books of his time. His surgical textbook remained the standard text for the next 200 years. In it he described massage as an essential adjunct to surgery. In the early 16 th century, Ambroise Pare, a French physician described the positive effects of massage in the healing process. He classified movements as gentle, medium and vigorous, and sought an anatomical and physiological foundation for mechanotherapy.

But it was not until the contributions of Per Henrik Ling (1776-1839), a Swedish fencing master, that a truly comprehensive and systemic compendium of massage was published in Europe . He traveled extensively to China and read the translations of the Chinese medical writings, which led him to develop the Ling System, also known as the Swedish Movement Treatment. This was a combination of massage and medical gymnastics, in which he classified movements as either passive or active. With this he established the Royal Swedish Central Institute of Gymnastics where he treated many patients wih his concepts of massage therapy.

From 1830 until 1920, massage developed from an obscure, unskilled trade to a field of medical health care. Modern massage therapy is credited to Dr. Johann Mezger of Holland (1839-1909), who enabled massage to be taught as part of the curriculum in medical schools of Germany and Scandinavia throughout the 19 th century. This increased the development and use of Long’s system of manipulation. These early massage methods were very vigorous, following the guideline of Ling’s system. People such as Professor Charcot (the teacher of Freud), Albert J. Hoffa (Technik der Massage) in Germany and James B. Mennell were influential in moving the development of massage therapy towards a gentler, less painful approach to the body, away from Ling’s System. Mennell illustrated this in his book, Physical Treatment by Movement, Manipulation and Massage, much of which was based on the research and documentation of Championniere.

But this movement towards a softer approach eventually led massage away from medical practice, as many methods utilized in the early 20 th century were painful, perhaps giving rise to the philosophy, "No pain, no gain". The use of machines to replace manual treatment, and the rise in the pharmaceutical industry, which allowed more patients to be treated in a shorter time, removed the personal nature of medical care, and with it the personal approach of massage.

Karen Clickner, N.D., L.M.T. has been a bodyworker for more than 25 years with advanced training and experience in Neuromuscular Therapy and Myofascial Release. She has taught throughout the eastern U.S. and Europe as well as published numerous articles regarding aspects of bodywork. She is the founder and director of ISIS Holistic Clinic in Brookline, MA and is a practicing Naturopath and medical herbalist