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Objectives
1
Upon completion of this chapter, the student will be
able to:
■
Identify the four ancient river valley civilizations
that used massage
■
Describe the essence of the Hippocratic Oath
and its relation to massage therapy
■
Name at least three ancient Greek and Roman
physicians who recommended massage
■
Explain the difference between development of
the arts, science, and massage in Europe and
that in the Arab countries during the Middle Ages
■
Describe how massage therapy was affected by
the Renaissance period
Key Terms
Anointing: Ritualistic or religious activity of rubbing oil
into the skin.
Bodywork: Treatment that involves manipulation of
the client’s body as a way to maintain or improve
health.
Gymnastics: Activity at ancient gymnasiums that
included exercise, massage, and baths.
Massage: Manual therapy involving pressure applied
with the hands (term started by the French explorers
in the 1700s).
Mechanical effects: Therapist applies pressure or
manipulation to physically change the shape or
condition of the client’s tissues.
Metabolic effects: Combined result of mechanical and
reflex effects on the whole body.
■
Identify the transition that occurred in American
healthcare in the 19th century
■
Describe the difference between massage and
bodywork
■
List the nine categories of bodywork
modalities
■
Name at least two indications that massage is
evolving in the American healthcare system
■
Identify at least two attributes of a massage
therapist that are needed for successful
employment in a spa
■
Name at least three current trends in massage
education
Modality: A collection of manual therapies that tends
to use similar applications of movement or massage
strokes to reach a similar goal.
Movement Cure: American version of Ling’s
movement system.
Re ex effects: Therapist stimulates the client’s sensory
neurons, which triggers the client’s nervous system to
change the shape or condition of the tissues in areas
that were addressed as well as other, related areas.
Swedish Gymnastics: A therapeutic movement
system developed by Per Henrik Ling.
Swedish Movements: Europe’s version of Ling’s
movement system.
Qi (CHEE): A dynamic, changing energy force that
runs through the whole body, supplying and being
supplied by body processes and activities.
1
2 INTRODUCTION TO MASSAGE THERAPY
elcome to the world of massage therapy! You are about
to embark on a most rewarding journey, discovering
W
what is involved in becoming a professional massage
therapist. This chapter covers the history of massage and
events that led to the current practice of massage. We define
massage and distinguish it from bodywork because so many
different bodywork techniques have been developed, and
there is a lack of clarity regarding the difference. Whereas
bodywork is a manipulative treatment of a client’s body that
is intended to maintain or improve health, massage requires
manual pressure on the client’s tissues, applied with the therapist’s touch, to maintain or improve health. We identify nine
Throughout thousands of years and a myriad of cultures,
people have used massage for communicating, relieving pain
or discomfort, healing, protecting, or improving one’s overall health. Most people have experienced the instinctive or
intuitive use of massage when stopping to rub or hold an
injury, bruise, or area of discomfort on the body.
categories and briefly summarize some of the massage modalities that have developed over time. The active development
of so many kinds of specialized bodywork is partly due to the
latest touch research. We introduce the concept of touch and
illustrate the increased interest in scientific research on the
topic. As the academic and scientific world proves the value
of touch, massage becomes more a part of the American
healthcare system. Continued involvement in the medical and
healthcare communities is accompanied by some changes in
massage education, also discussed in this chapter. A general
understanding of these concepts can provide a solid foundation for you as you build your professional massage practice.
Historical references to massage have been found in
cultures around the world. To better comprehend that
massage is found in many cultures, you can examine the
different terms used to describe the same or similar activity (see Table1-1). Even cultures without written language
have passed down the tradition of massage and techniques,
Root/Term Meaning Culture/Person
Amma to calm by rubbing, or press-rub Chinese
Anatripsis to rub up Greek/Hippocrates
Anma to calm by rubbing, or press-rub Chinese
Anmo to calm by rubbing, or press-rub Chinese
Kampo “the Chinese way” Japanese
Makeh to press softly Sanskrit
Mass to press softly Arabic
Mass’h to press softly Arabic
Massa to touch, handle, squeeze, knead Latin
Massein to touch, handle, squeeze, knead Greek
Masser to knead by hand French
Masso to touch, handle, squeeze, knead Greek
Mordan to rub Indian
Samvahana hand rubbing Indian
Chapter 1 / Welcome to the World of Massage Therapy!
3
shown by the notes of early explorers who “discovered”
these native people.
In the most primitive civilizations, medicine was ritualistic and oftentimes combined with magical or mystical
activities, as people believed that illness came from demons,
spirits, or sins. Shamans and priests used massage, among
other practices, to help rid people of these evil entities.
The spiritual and medical traditions were passed on from
generation to generation, perpetuating the practice of massage. Evidence of this is found everywhere from Australia to
Africa, including ancient Egypt, to the Pacific Islands, Russia
and the Ukraine, and North and South America.
Ancient civilizations used massage in conjunction with
many variations of water therapy to cleanse and purify the
body of disease-causing spirits: bathing, steam rooms, hot
springs, and sweat lodges. These rituals that combined massage with water therapies persisted throughout history and
still exist today.
Ancient River
ValleyCivilizations
(7000–1000
The oldest civilizations were created by groups of people
who were able to feed and house large populations efficiently.
Large-scale agricultural practices were developed; complex
architectural structures were designed and built; political and
religious organizations were established; the arts, sciences,
and medicine were explored; and written records were kept.
One of the most important requirements for civilization
was a dependable source of water. Large rivers were able
to sustain large populations and, as a result, there are four
areas in the world where ancient river valley cultures were
established: the Yellow River, the Indus River, the Tigris and
Euphrates Rivers, and the Nile River (see Fig.1-1).
The exact dates that these river valley civilizations were
established are controversial because it is unclear from the
BCE )
remaining ancient records when they were actually written.
Additionally, records have been translated and rewritten a
number of times, occasionally making the original intent
and message questionable. For the purpose of this book,
civilizations in these four areas developed during the same
time period, many thousands of years ago.
Tracing massage history accurately is complicated
because ancient references to massage do not use contemporary terminology or techniques. Early records of massage
being used in healthcare can be found in documents from
all of the ancient cultures. Some of the earliest records of
massage refer to “anointing” (ah-NOYN-ting), which is a
process of rubbing oil into the skin, often used to banish evil
influences that caused disease, again demonstrating the spiritual and religious basis for healthcare. This section of the
chapter introduces massage as it evolved in different areas of
the globe over time, eventually developing into the current
massage therapy profession.
Ancient China
The Yellow River valley culture is also referred to as Shang
China, or Ancient China. There is widespread and extensive
massage information found in ancient Chinese records. One
of the ancient Chinese documents of disputable age is the
Cong Fou , which includes information on the use of medici-
nal plants, controlled breathing, and a system of exercises
and positions for healthcare. It is questionable whether massage treatment was actually included, but many assume it
was. Possibly started around 2700 , the Cong Fou may
have been completed over several generations.
The Nei Ching is the Yellow Emperor’s classic of internal
medicine and is one of the oldest medical references that still
exist. Some claim that it was written around 2600 because
of its association with the Yellow Emperor of China, who died
at about the same time. Others suggest that it was written
from 475 to 220 as a series of entries by many different
persons but linked to the famous and honorable emperor to
establish its authority and bring it fame. The Nei Ching is more
of a medical dialogue or discussion than a medical reference
Figure 1-1. The four ancient river
valley civilizations.
Egypt
The Nile
Mesopotamia
Tigris and Euphrates
China
Yellow River
India
Indus and Ganges
4 INTRODUCTION TO MASSAGE THERAPY
book and serves as the foundation for traditional Chinese
medicine. Its main topics include the theory of five phases and
the balance of yin and yang. These concepts are introduced
in Chapter 11, entitled “Complementary Modalities,” which
compares Eastern and Western approaches to healthcare.
In the Chinese language, words are represented by contextual pictograms. Translating, reading, and writing the words
in English letters can be subjective and vague. AChinese
word written in English is an attempt to spell the pronunciation of the word. One of the oldest Chinese terms for a therapy involving massage-like activity is commonly written as
moshuo (moh-SZH-woh). This term can be found in the Nei
Ching in the context of massage and finger pressure used to
energize someone or treat paralysis, chills, fever, and poor circulation of blood. As the Chinese language developed through
time, massage techniques were called anmo (AHN-moh), to
press and rub, and Tui-na (TOOY-nah), to push and hold.
From China, bodywork made its way into Japan and
provided a source of employment for blind people. Since the
Japanese culture tends to shun the disabled, few professions
were available to the blind outside of acupuncture and massage therapy. With refined perceptions of touch, blind acupuncturists and massage therapists were very successful and
able to gain respect. While the Japanese developed many
different forms of bodywork, Shiatsu is the best known.
Figure1-2 is a photo taken prior to 1895 of a blind massage
therapist performing Shiatsu on a client.
Ancient India
The Indus River is the site of the largest ancient river valley civilization discovered in the 20th century. This area of
ancient India is near current day Pakistan. Unlike the others, the Indus Valley civilization did not leave a lot of written
records to provide clues to their culture. There are four original scriptural texts, the Vedas, which may have been written
over 5,000 years ago. It is believed that these lengthy, complex verbal messages from the gods were spoken directly to
sages and only shared by word of mouth for generations.
Eventually, these messages were written down in poetic,
lyrical form as the Rik Veda, Sama Veda, Yajur Veda, and
Atharva Veda. Because the words were passed down only
verbally for so many generations, the rhyming patterns may
have been instrumental in the accuracy of the translation.
The Ayur Veda, a supplement to the Atharva Veda,
discusses pharmacology and health. Its age is questionable,
some claiming it was written around 3000 , and others,
1000 or later. The teachings of the Ayur Veda provided
the basis for Ayurvedic healthcare, which is gaining popularity in the Western world. The holistic approach attempts to
balance the body, mind, and spirit to maintain health and
prevent illness. Some of the many therapies employed in this
natural system of healing include herbs, diet, fasting, aromatherapy, massage, meditation, yoga, color, and metal therapy.
Ayurvedic references made to massage include samvahana (hand rubbing), mordan (to rub), and most importantly,
shampooing. Shampooing was a medical treatment done with
a brush and the hands for treating health problems. Massage
was and continues to be used regularly in the Indian culture.
Figure 1-2. Blind Japanese masseur treating a patient. (Reprinted
from Kellogg JH, Harvey JK. The Art of Massage. Battle Creek,
MI: Modern Medicine, 1929.)
Ancient Mesopotamia
The area of ancient Mesopotamia lies between the Tigris
and Euphrates Rivers, in the area that is now called the
Middle East, near Iraq. The earliest people may have arrived
in Mesopotamia somewhere around 7000 , but civilization began around 3000 .
Ancient Mesopotamians developed a written language
called cuneiform. A series of wedge-shaped dents were made
in wet clay, and when the clay dried, the clay tablets were
portable, storable, and long lasting. Clay tablets and paintings on the walls of tombs have shown evidence of massage
being used for healthcare. See Figure 1-3 for a photo of an
ancient Babylonian clay tablet, circa 300 , which includes
a reference to massage.
Physicians and priests both practiced medicine in
Mesopotamia, another example of the relationship between
illness and evil spirits. Even so, Mesopotamians had some
understanding of anatomy and were able to diagnose and
prescribe treatment for many specific medical conditions
as well as perform surgeries. Babylonian King Hammurabi
established a set of laws called the Code of Hammurabi,
Chapter 1 / Welcome to the World of Massage Therapy!
Figure 1-3. Clay tablet of medical text from Babylonia, 300 BCE.
(Reprinted with Martin Schøyen’s permission from the Schøyen
Collection MS4575, Oslo and London.)
5
medicine was handled by priest-physicians who typically attributed health conditions to the work of gods and goddesses.
Prayers, spells, amulets, herbal salves, and poultices were treatments often used in hopes of a cure. Additionally, records of
intricate surgeries and more advanced medical knowledge
were also found. The Kahun Papyrus, written around 1800
and found in fragments in 1889 , focuses on gynecological
matters. One of the passages specifically indicates the use of
massage for a woman whose legs ache (see Fig. 1-4).
Medical conditions, prescriptions, diagnoses, and
surgical treatments were documented in various papyri,
as were details about the mummification process leading the deceased safely to the afterlife. The child king
Tutankhamun’s famous tomb and mummy demonstrate the
extensive mummification process of the ancient Egyptians.
The process required the removal of internal organs, leading
the Egyptians to a thorough understanding of anatomy.
There is evidence of massage being used in ancient
Egyptian healthcare from as early as 4000 , when the
mortal goddess Queen Isis included massage as treatment
for health and healing. There is no evidence from the other
ancient river valley cultures of any female healers, so it is
probable that she was the first. She also trained her priestesses to perform the duties of a physician, massage being
one of them.
which includes the oldest code of medical ethics. It recommends an “eye for an eye” philosophy that is certainly questionable by today’s standards.
Ancient Egypt
Located on the Nile River, the fourth of the ancient river valley civilizations is now called Northern Africa. The history
of ancient Egypt follows a timeline similar to that of China
and Mesopotamia. Instead of using pictograms on walls and
cuneiform on clay tablets to convey messages, the Egyptians
developed a more complex writing system of hieroglyphics
and invented papyrus (puh-PAHY-rus) paper.
The papyrus plant was a reedlike plant found along the
banks of the Nile that was used to fabricate, among other
things, a useful and durable paper with a secret recipe that
no other culture could replicate. Produced in lengths of
35feet or longer, the papyrus paper could be rolled up for
storage and transport, unlike the Mesopotamian clay tablets.
Unfortunately, the Egyptians used up the local supply of
papyrus, their secret recipe was lost, and papyrus paper was
not made again for thousands of years.
Many of the ancient papyrus records have been discovered, named, and translated. Topics covered all aspects of the
culture, including literature, governmental tax records, religion,
magic, and medicine. As in other early ancient civilizations,
Figure 1-4. Kahun medical papyrus from 1825 BCE. (Reprinted
from Griffith FL. The Petrie Papyri: Hieratic Papyri from Kahun
and Gurob. London: Bernard Quaritch, 1898. © Petrie Museum of
Egyptian Archaeology, University College London UC 32057.)
6 INTRODUCTION TO MASSAGE THERAPY
Figure 1-5. Ankhmahor’s tomb illustrating bodywork. (A) Photo of the tomb wall (by Trudy Baker, taken from www.foot-reflexologist.com/
EGYPT). (B) An artistic rendition of inscription, sometimes claimed to be a painting from the tomb.
The tomb of Ankhmahor, dated somewhere around 2350
, has been called the Tomb of the Physician. His title as a
physician has been disputed; one theory suggests that he was
only a ka-priest who had farming duties and served the king.
Regardless, Ankhmahor’s tomb has images of foot manipulation and surgical operations such as circumcision. There are
many who believe that the images depict foot reflexology, but
it is also possible that foot surgery is being shown. The hieroglyphs accompanying the pictograph have been translated
with the patient saying “Do not cause pain,” and the therapist
responding “I will act so you shall praise me” (Fig. 1-5).
Ancient Greece
(750
Although not one of the original river valley civilizations,
there is evidence of human activity in Greece thousands of
years ago. Written records can be found from about 2000 ,
but what little has been deciphered does not reveal any
advanced works of literature like those of the other civilizations of the time. Early evidence of the Greek alphabet dates
from around 750 .
Massage in Ancient Greece
The Greek health regimen included exercise, massage, fresh
air, rest, diet, and cleanliness. Exercise and competitive athletics were so much a part of the culture that the Olympic
Games were held every 4 years as part of a religious festival.
These games were very important to the Greeks, who even
stopped wars to compete in them. Physical training was critical to good performance, giving rise to gymnasiums all over
the country. Athletes and military of the day received their
BCE –500 CE )
academic, art, and physical training at the gymnasiums.
Baths, also an important aspect of the health regimen, were
attached to or located near the gymnasiums. In time, the
baths and gymnasiums served the general public as social,
spiritual, mental, and physical gathering places.
Massage was one of the primary treatments provided
at the Greek gymnasiums and baths throughout their existence. Athletes received special massage treatments to minimize exhaustion and tone the muscles. The aliptae were
servants who provided this ritual before and after competition and became very knowledgeable about the muscles,
the condition of muscles, and muscular activity during exercise. In a way, the aliptae were the predecessors to physical or athletic trainers. Massage was used so commonly in
the gymnasiums that the term “gymnastics” referred to
the combination of exercise, massage, and baths. Although
ancient Greek records do not contain an abundance of specific information about massage, some detailed references
to massage were made by the famous Hippocrates, who
was also responsible for important scientific and medical
advancements around 400 .
Hippocrates of Cos
Hippocrates (hih-PAH-kruh-teez) was an ancient Greek physician who lived between 460 and 370 . He is considered
the “Father of Medicine” for a couple of reasons. He was
the first influential physician to observe health and disease as
a result of natural causes and establish medicine as a science,
rejecting the theory of health and medicine as the work of
magic and gods. Also, he was the first to introduce a medical
code of ethics different from the eye for an eye philosophy
outlined in the Laws of Hammurabi.
The Hippocratic Corpus is a series of 60 treatises discussing medicine and medical principles. Its several different
Chapter 1 / Welcome to the World of Massage Therapy! 7
styles of writing and many contradictory statements led to
the belief that Hippocrates started the project but its completion occurred long after he was gone. Within the Corpus,
the Hippocratic Oath is a statement in which physicians
swear to respect, honor, and share knowledge with their
teachers; promise to treat their patients to the best of their
ability and only with good intentions; swear that they will
not prescribe a deadly drug or treatment under any circumstance; and vow patient confidentiality in hopes of enjoying
life and gaining respect from others. This is the philosophy
with which Hippocrates practiced medicine, and it continues
to be the foundation of the ethical codes for many healthcare professions including massage therapy. The Hippocratic
Oath to “do no harm” provides the basis for professionalism,
which is discussed in the next chapter.
See Box 1-1 for a translation of the Hippocratic Oath.
A Translation of the
Hippocratic Oath
by Francis Adams
Evidence of Massage in the
Hippocratic Corpus, volumeIII,
“On the Articulations” and
“Onthe Surgery,” translated
byFrancis Adams
“On the Articulations” is a discussion of a dislocated
shoulder suggesting in Part 9:
. . . the shoulder should be rubbed gently and softly.
The physician ought to be acquainted with many things,
and among others with friction; for from the same name
the same results are not always obtained; for friction
could brace a joint when unseasonably relaxed, and relax
it when unseasonably hard; but we will define what we
know respecting friction in another place. The shoulder,
then, in such a state, should be rubbed with soft hands;
and, moreover, in a gentle manner, and the joint should be
moved about, but not roughly, so as to excite pain. Things
get restored sometimes in a greater space of time, and
sometimes in a smaller.
“On the Surgery” states in Part 17:
Friction can relax, brace, incarnate or attenuate: hard
braces, soft relaxes, much attenuates, and moderate thickens.
I swear by Apollo the physician, by Aesculapius, Hygeia
and Panacea, and I take to witness all the gods, all
the goddesses, to keep according to my ability and my
judgment the following oath:
To consider dear to me as my parents him who taught
me this art; to live in common with him and if necessary
to share my goods with him; to look upon his children as
my own brothers, to teach them this art if they so desire
without fee or written promise; to impart to my sons and
the sons of the master who taught me and the disciples
who have enrolled themselves and who have agreed to the
rules of the profession, but to these alone, the precepts and
the instruction.
I will prescribe regimen for the good of my patients
according to my ability and judgment and never do harm
to anyone. To please no one will I prescribe a deadly drug,
nor give advice which may cause his death. Nor will I give a
woman a pessary to procure abortion.
But I will preserve the purity of my life and my art. I will
not cut for stone, even for patients in whom the disease
is manifest; I will leave this operation to be performed by
practitioners (specialists in this art). In every house where I
come I will enter only for the good of my patients, keeping
myself far from all intentional ill-doing and all seduction,
and especially from the pleasures of love with women or
with men, be they free or slaves. All that may come to my
knowledge in the exercise of my profession or outside of
my profession or in daily commerce with men, which ought
not to be spread abroad, I will keep secret and never reveal.
If I keep this oath faithfully, may I enjoy my life and
practice my art, respected by all men and in all times; but
if I swerve from it or violate it, may the reverse be my lot.
Hippocrates’ original holistic methods included exer-
cise, massage, fresh air, rest, diet, and cleanliness. Hippocrates
promoted the concept that the body is capable of curing itself.
As you move through your massage education, you will discover that massage techniques help the body to cure itself
or to encourage self-healing. Human touch is an incredibly
powerful part of this process.
Although there is only brief mention of massage in the
Hippocratic Corpus, the information is detailed and specific.
Anatripsis (to rub up) was developed by Hippocrates as a
method of rubbing toward the heart, from the extremity to
the core, to increase circulation. His technique for increasing circulation is still taught today and is one of the major
benefits of massage. He recommended that all physicians be
trained in anatripsis because it could promote healing; adjust
the tension at a joint; and tighten, relax, or build muscle.
See Box 1-2 for translation of the part of the Hippocratic
Corpus that refers to massage.
Ancient Rome
(750
Legends tell of illegitimate twin brothers, Remus and Romulus,
who were left to die in the Tiber River but were rescued
and raised by a wolf. One of the stories ends with Romulus
BCE –500 CE )
8 INTRODUCTION TO MASSAGE THERAPY
murdering Remus and founding Rome in 753 . Another
story describes the two brothers founding the city of Rome
together. With the beginning of Rome being based on myth, it
is difficult to know what the ancient Roman lifestyle was truly
like. Records dating to 500 provide dependable history, but
before that time, Roman lifestyle is somewhat of a mystery.
It is clear that the Greek culture influenced Roman religion, entertainment, sports, and medicine. The Greek physicians, considered superior to the Roman physicians, gained
status and recognition within the Roman culture by serving
Roman royalty. With Greek medicine came the Greek health
regimen and its terminology. Exercise, massage, and baths were
collectively called “gymnastics” back in 400 , and that term
has maintained its association with massage throughout history.
Greek Physicians in
Ancient Rome
Asclepiades of Bithynia (124–40 ) was a Greek physician
who settled in Rome and promoted diet, exercise, bathing, and
massage. His approach to medicine differed from Hippocrates’
because his theory for health was based on a balance between
tension; relaxation; and movement of very small, individual
particles within the body called atoms. He believed that free,
fluid movement of the atoms promoted health, and irregular,
inharmonious movement caused disease. To restore atomic
harmony, he used movement therapies such as massage,
swinging, and vibration. His methods were so popular that
many other physicians adopted and practiced his theory.
Aulus Cornelius Celsus (25 –57 ) was another
prominent figure in ancient Roman medicine and massage.
A follower of Hippocrates, he wrote a series of eight texts
called De Medicina , which covered many different facets of
health and medicine. Its preamble reviews the philosophies
of Celsus’ contemporaries and follows with a summary of
his own approach to the art of medicine. First, he describes
how health providers should act, then he shares his observations of diseases, and finally he discusses treatments. There
are numerous references to massage throughout the work,
indicating its use in the treatment of the following 1 :
At the time it was written, somewhere around 30 ,
De Medicina was just another piece of medical literature.
However, in the late 1400s, the work was rediscovered in
Italy, printed, published, and circulated and now is celebrated
as one of the earliest remnants of Western medicine.
Claudius Galenus (130–201 ), also known as Galen, is
possibly the most famous of the Greek physicians in Rome.
Another follower of Hippocrates, Galen revolutionized medicine not only by his many works on anatomy and medicine
but also by developing the experimental method of scientific
investigation. He encouraged physicians to practice dissection to discover anatomy and improve their surgical skills.
One of his books, Hygiene , includes a discussion on morning
and evening massage, a description of massage strokes and
muscle fibers being rubbed in every direction, as well as an
explanation of anointing with oil for health and well-being.
The Fall of Rome
The culture of the Greeks continued to influence Rome
until around 150 , when the fall of Rome began. In a series
of events, including loss of territory and control to other
cultures and religions, the power and glory of the Roman
Empire finally faded out around 500 .
The Middle Ages (400–1400)
Once the last of the Roman emperors was ousted, Europe
expanded northward with wars and battles for power and
control, and world history was changing. This period, which
lasted from the year 400 until 1400, is called the Middle
Ages. Understandably, European history took a unique path,
different from that of the rest of the world. Europe was significantly affected by the expansion and resultant wars, and
the Church took control of society and education. The Arab
world, however, was not involved in the European conflicts
and was not under the influence of the Church.
• A weak body or tense body, headaches, paralysis
(Book II: Chapter 14)
• Fevers (Book III: Chapters 9, 11, 12, 14)
• Paralysis, headaches, head cold (IV:5); neck spasm
(IV:6); asthma (IV:8); cough (IV:10); flatulence, ulcers
(IV:12); stomach pain (IV:13); lung disorders (IV:14);
liver disorders (IV:15); spleen disorders (IV:16); intestinal distress (IV:20–23); diarrhea (IV:26); menstrual
cramps, urinary disorders (IV:27); joints (IV:29, 30);
healing (IV:32)
• Eye disorders (VI:6); ear disorders (VI:7); nose disorders (VI:8); fractures (VI:10); gum disorders (VI:13)
• Dislocations (VIII:11)
Middle Ages in Europe
The Middle Ages in Europe are sometimes referred to as
the Dark Ages. There was an absence of art, literature, science, medicine, and cultural development, and many written records were lost or destroyed amid the chaos of war.
Gone was the luxurious lifestyle of the Romans. Despite
the territorial battles, the Church maintained a strong presence throughout Europe. By salvaging and preserving some
of the historical material, the Church became one of the
primary sources of learning during the Middle Ages and
became a powerful influence over society.
The Christian influence affected European culture for
a thousand years. Teachings of the Church were strongly
Chapter 1 / Welcome to the World of Massage Therapy!
9
enforced; heretics were severely punished; independent,
creative, progressive thought was discouraged; and development of the arts and sciences came to a screeching halt.
Public baths and gymnasiums were abolished by the Church
because of the increase of sexual improprieties. Women
who provided healthcare were often accused of being
witches with supernatural or magical activities and burned
at the stake, some theorize because they posed a threat to
the male doctors. With the advent of the Christian era, massage became synonymous with witchcraft, and the practice
declined in Rome and most of Europe.
Fortunately, there were women who managed to keep
touch alive during the Dark Ages. The Church operated
hospitals in which nuns were granted permission to provide
basic care to victims of war. Women from all walks of life
eventually joined the nuns at the hospitals to care for patients,
and massage and baths remained inexpensive treatments that
women could provide. Incidentally, these oppressed women
made great advances in women’s rights toward the end of
the Middle Ages, getting involved in politics, land ownership,
science, literature, medicine, and education.
The Middle Ages in the
Arab World
Ibn Sina recommended health maintenance that included the
original Greek regimen of exercise, baths, and massage. He
also included massage as a treatment for relieving pain, for
increasing blood flow, and for facilitating the healing process.
The Renaissance (1450–1600)
As Europeans tired of the cultural stagnation imposed by
the Church, their curiosity and interest in the arts and sciences was revitalized. The Renaissance (French for rebirth)
period started with this renewed burst of progressive thinking. During the Renaissance, medicine and art developed
simultaneously, as renowned artists of the day studied and
illustrated human anatomy and physiology.
Leonardo da Vinci’s (1452–1519) illustrations of the human
body and anatomy drawn during this period still exist today as
some of the most admired medical illustrations. His studies of
the human anatomy were often done in secret, since human
dissection was not yet widely accepted in Europe. Figure 1-6
shows an example of Leonardo da Vinci’s anatomical art.
Women in the Arab world were also participating in healthcare
during the Middle Ages, even if only serving as slaves who provided massage in the Turkish baths. While Europe suffered a
thousand years with little progress, the Arab world continued to
build upon the Greco-Roman knowledge base. The Arab countries were not constrained by the rules of the Church, which
allowed them to use creativity, invention, and progressive thinking. They performed dissection on human cadavers, which was
unacceptable in the Christian realm, and were able to advance
anatomical knowledge. Al-Razi and Ibn Sina are Arabs who used
massage and are famous for their contributions to medicine.
Al-Razi (854–935 ), known in Latin as Rhazes, was an
Islamic philosopher and physician. He wrote a medical encyclopedia that included knowledge from Arabic, Roman, and Greek
physicians. He was especially interested in the interaction
between psychology and physiology, gathering very detailed
medical histories from his patients prior to diagnosing or prescribing. Because Al-Razi understood that health was affected
by the state of mind, he considered preventive health maintenance very important. He perpetuated the use of massage as
part of the health regimen as well as a treatment for disease.
Ibn Sina (980–1037 ) is also known by his Latin name,
Avicenna. He was a scholar, physician, and follower of the
philosopher Aristotle. He wrote hundreds of books on a variety of subjects, but his greatest accomplishments were medical treatises. His Canon of Medicine is a systematic, useful,
encyclopedic medical text that builds upon Galen’s theories
and observations. When revived after his death, it was quickly recognized as an excellent teaching text that was translated
and used in medical schools across Europe for over 500 years.
Figure 1-6. Leonardo da Vinci’s anatomical illustrations.
(Reprinted from Clayton M. Leonardo da Vinci: A Singular Vision.
New York: Abbeville Press, 1996.)
10 INTRODUCTION TO MASSAGE THERAPY
Figure 1-7. Anatomical illustrations by Andreas Vesalius showing muscular detail. (Reprinted from Saunders JB de CM, O’Malley CD.
The Illustrations From the Works of Andreas Vesalius of Brussels. New York: Dover Publications, 1973.)
Another anatomical artist from the Renaissance is Andreas
Vesalius (1514–1564) of Belgium. As a child, he felt compelled
to learn anatomy, dissecting any unfortunate animals he could
find. He found himself dissatisfied with his education at a
medical school in Paris, partly because the teachers were fixed
on Galen’s philosophies and were still dissecting animals to
understand human anatomy. He returned to Belgium so passionate about learning human anatomy that he stole a cadaver
to dissect the body. Vesalius paid special attention to the muscles and their attachments and actions, making his contribution to massage history especially notable. Figure 1-7 shows an
example of the anatomical art of Andreas Vesalius.
In his distinguished book De Humani Corporis Fabrica , pub-
lished in 1543, Vesalius states, “It was when the more fashionable doctors in Italy, in imitation of the old Romans, despising
the work of the hand, began to delegate to slaves the manual
attentions they deemed necessary for their patients . . . that
the art of medicine went to ruin.” 2 Thissignificant statement
resonates with society today. Many people feel frustrated and
disappointed with the medical community’s personal disconnection and professional distancing, which fails to create a
trusting relationship. Massage is a complementary therapy
that can bridge the healthcare gap between clinical doctors
who barely know their patients and the very personal and
reassuring attention that human touch can provide.
The dualism theory of Rene Descartes (1596–1650),
“Ithink, therefore I am,” began the exploration into mind–
body connection. In his book Meditations VI , he claims that
the human body is like a machine: “so likewise if the body
of man be considered as a kind of machine, so made up
and composed of bones, nerves, muscles, veins, blood,
and skin, that although there were in it no mind, it would
still exhibit the same motions which it at present manifests
involuntarily.” 3 He drew a distinction between the mechanical body and the emotional mind but also claimed that they
were interconnected. He was the first to differentiate between
the human body and a human being, which continues to be a
philosophical argument of medical ethics even today.