The History and Present Positionof Massage and Gymnastics.

INTRODUCTION.
FROM time immemorial people of all races have had some idea of the
hygienic and therapeutic importance of physical exercise. Gymnastics
in some form has therefore always been used, sometimes as exercise in the open air, sometimes, and especially in the ancient civilisations, as a more or less developed system of positions and movements.
It has also been understood from time immemorial that many local and general diseased conditions may be cured or relieved by mechanical
treatment of the soft parts in the form of movable pressure, by stroking,
rubbing, kneading, as well as by clapping and beating. Massage, as
well as gymnastics, is a very ancient form of treatment, so ancient that one may consider its history to be as old as that of mankind, and its beginning prehistoric.
Gymnastics and massage, treatment by exercise of the motor apparatus,
and treatment by manipulation of the soft parts have so much in com- mon that their history may well be given together. Both methods of
treatment are practised by the same craftsmen, and have so much in common that unintelligent people who have used them both for years
are often unable to draw a distinction between them which can be understood by people of ordinary intelligence. For the most part, nowadays,
in all civilised countries a distinction has been made with more or less clearness between massage and gymnastics.
It has been the fashion among historical writers on the subject to
assert that the earliest writings on massage and gymnastics are found
in Kong-fu’s Chinese ” White Books,” of great but uncertain antiquity,
as well as in the earlier of the Indian Vedas, called the ” Ayur-Veda,”
written by Susruta, the pupil of Dhavantare, who is said to have lived
in the eighth century. According to Nebel, no clear expositions of
medical gymnastics nor evidence of Chinese massage of remote antiquity
are found in Kong-fu’s work, and Daily’s complaint against the Swedish
gymnasts of having plagiarised from their Chinese colleagues is absurd.
Neither has Professor Pagel of Berlin found anything on these subjects
in the ” Ayur-Veda,” but this does not throw doubt on the fact that
mechano-therapy, especially in the form of massage, is many years old
in India, and probably also in China.*

  • See, concerning ancient Asiatic mechano-therapy, Pere Amyot’s
    ” Memoire con- cernant les Chinois “
    (1776), Lepage’s
    ” Recherches Historiques sur la Medecine des Chinois “
    (1813), Hue’s ” L’Empire Chinois “
    (1831), Dr. Wise’s ” Commentary on the Hindoo System of Medicine,” Calcutta, 1845, and H. Nebel’s articles in Langenbeck’s “
    Arkiv.,” Bd. 44, and in ” Deutsche Med. Wochenschrift, 1887.”
    M.G. 1
    2 MASSAGE AND GYMNASTICS.
    The ancient Egyptians probably knew massage and medical gymnastics^in some form.*
    From the ancient Greeks we have interesting information on the
    subject. Gymnasia with their attendants (the chief “
    physical treat- ment ” quacks of ancient Greece its ” gymnastic directors “) were
    the places for such treatment. Herodikos, or as he is also called Prodikos
    of Selymbria, who appeared shortly before Hippocrates, was such a gymnastic director of the cocksure uncritical type, and treated even
    febrile diseases with a form of “
    terrain-cure.”
    Hippocrates (460 377 B.C.) mentions the utility of friction after sprains and reduced dislocations, recommends abdominal kneading for constipation, knew of chest-clapping, “
    terrain-cures,” etc. Among the many benefits of culture which Greece imparted to the
    conquered Romans were some in the department of medicine, and
    mechano-therapy flourished in Rome, chiefly owing to Greek influence. Some of Rome’s most famous doctors were Greeks, and among their names is that of Asclepiades, who practised shortly before the Christian
    era, and who employed massage and gymnastics freely, and according
    to Pagel seems to have been the father of mechano-therapy in the Romanworld. We learn also from Roman literature t in the dawn of our own
    time that both gymnastics and massage were highly valued by the
    profession and the public. The fact that Galen (A.D. 131 201), the most
    eminent doctor of the Roman Empire, gave it great attention had an
    important influence on mechano-therapy. His influence, as we know,
    extended several centuries beyond his own time, and it is partly due to him that this method of treatment did not entirely fall out of use in the
    Middle Ages. Thessalus of Tralles, Aretacus of Cappadocia, Rufus of
    Ephesus, bear witness that both gymnastics and massage had a certain
    time of prosperity under the Roman Empire. It is very interesting to
    find that the last-named shows the scientific spirit by mentioning kidney
    disease as a contra-indication to gymnastics. Obesity, gout, paralysis
    and many other diseases were treated by mechano-therapy. About
    A.D. 250 Flavius Philostrates produced his great work on this method of treatment. Alexander of Tralles and Paul of yEgina also belong to this period. The latter specially mentions mountain climbing. In the fifth century Oribasius wrote his well-known work, which is our chief source of
    knowledge of ancient mechano-therapy ; in the sixth century we find from a work on the treatment of obesity that gymnastics was still alive ; in the seventh century Ae’tius of Amida wrote of active and passive
    movements, resistance movements (see later concerning Ling), nid
    friction. The further we follow the literature of the Middle Ages, the fewer
    signs of life do we find in mechano-therapy, and it seems to share the
    fate of all knowledge in not being able to advance without at the same
    time losing much of what has already been won. It is obvious that the
  • Prosper Alpinus : ” De re Medica Egyptorum, 1591.” Regarding ancient European
    raechano-therapy, see C. Keyser’s Latin translation of” Flavius Philostrates,” Heidelberg, 1840 ; ” (Euvres d’Oribase, Bussemaker and Daremberg,” Paris, 1851 ; Pagel, “
    Einfiih- rung in d. Geschichte d. Medizin,” Berlin, 1898.
    t ” De Medicina ” the work of Aulus Cornelius Celsus, in German, by B. Ritter, Stuttgart, 1840.
    INTRODUCTION. 3
    seeds sown by previous generations would find the conditions of life unfavourable in an age which more and more turned away from experi- ence towards pure speculation, and finally took refuge in complete
    mysticism. It is true that the Arabs, whose dominion over medicine
    (from the ninth century) extended over several centuries, followed for the most part the teaching of Galen, and could not therefore quite
    neglect a treatment so highly valued by him. Avicenna, in particular
    (born A.D. 980), was interested in physical treatment, especially gymnastics. The monks, too, who were the chief practitioners of medicine in
    this period, were, as doctors, followers of Galen. But the Arabs turned
    in preference to pharmacology for their therapeutics, and the monks
    found prayers and exorcising easier than massage and gymnastics.
    From the thirteenth century we have two rather important works, one by Johan de St. Amand of Tournay, the other by Petrus of Apono,
    who discussed the hygienic and therapeutic value of physical exercise. In the fourteenth century anatomy began to free itself by degrees
    from the traditions of Galen, and reached during this and the two follow- ing centuries a comparatively secure position. One of the conditions for the development of mechano-therapy was thus fulfilled, and it was not
    long before various signs of new life were apparent in this field. The
    great Ambrose Pare (1517 1590) warmly upheld mechanical treatment,
    and tried to base it on anatomical and physiological grounds, a fact of
    greater importance than the favour shown at the same time towards
    gymnastics by the brilliant charlatan Paracelsus. We find, moreover,
    in the sixteenth century many scientists and doctors who may be considered worthy of mention in a historical survey of this kind : Leonard
    Fuchs in Germany, Timothy Bright in England, Champier du Choul and
    Faber de Saint Jory in France, Antonius Gazi, Prosper Alpinus, Andreas
    Lacuna, Hieronymus Mercurialis, and Fabricius of Aquapendente in
    Italy. The last-named, in common with several other people, has been
    regarded by many as the originator of massage. The best-known work
    of this time is ” De Re Gymnastica Velerum,” by the renowned Hierony- mus Mercurialis (1569).
    Here, too, we find traces of the mighty genius and versatile activity of
    Lord Bacon of Verulam (1561 1626), and it is very interesting to see
    his wonderful acuteness asserting itself even on this subject. From one
    of his countrymen, Murrell, I quote Lord Bacon’s opinion on massage : “
    Frictions make the parts more fleshy and full, as we see both in men
    and the currying of horses. The cause is for that they draw greater
    quantity of spirits and blood to the parts, and again because they draw
    the ailments more forcibly from within, and again because they relax
    the pores and so make better passage for the spirits, blood and ailment ; lastly, because they dissipate and digest any inutile and excrementitious
    moisture, which lieth in the flesh, all which helps assimilation.” It is easy to translate these words, written about 300 years ago, and almost
    as much an expression of the dim and erroneous ideas of the time as of
    his own natural clear-sightedness, into the scientific language of our time,
    and to find in them at least surmises of the power of massage to counteract atrophy, to hasten the circulation, to promote the absorption of
    pathological tissue elements, and to improve general nutrition.12
    4 MASSAGE AND GYMNASTICS.
    The literature of the seventeenth century, especially of its latter half,
    shows many scattered signs of the use of physical treatment, although
    not to the extent one might have expected, judging from other
    phenomena of this time. The mechanical view of physiological processes began to assert itself more and more, and the ” gymnasts

    of this time
    rendered considerable service here as well as in the advance of anatomy.
    But their therapy was remarkably little affected by their theories, and
    neither gymnastics nor massage can be said to have gained very muchfrom their work. Borelli (1608 1679) meanwhile wrote his famous
    book,
    ” De motu animalium,” a bulky work which came out in 1670,
    and in which the mechanics of movement and of respiration were fully set forth. This work must have had some influence on the development
    of rational gymnastics. Another Italian, Baglivi, was much addicted to treatment by movement and friction, ” which give tone and suppleness
    to the limbs and tissues.” In England, according to Tissot, massage
    made marked progress during the seventeenth century, and evidence of
    this is found in literature. Sydenham lays stress upon the value of
    exercise in constipation, gout, etc. In 1666 a remarkable work was
    published by Dr. Henry Stubbe, a doctor practising at Stratford-onAvon, with the illuminating title ” An account of several marvailous
    cures performed by the streaking of the hands of Mr. Valentine Greatarick.” It is worth noting that Sir William Temple (the father of the Triple
    Alliance), who, whenever he had a presentiment of clouds in the political
    heavens or otherwise found the troubles of a statesman’s life too heavy, was in the habit of retiring to “
    his little nest at Sheen “
    to divide his time between gardening and literary work, this cautious gentleman
    I say, wrote an essay on
    ” Health and Long Life,” as well as much else, in which the value of massage is considered and in which it is specially
    recommended for the treatment of joint affections. Guyon wrote in 1615 his “
    Miroir de la beaute,” in which he calls massage to the service of beauty (for which it can seldom be of much use). J. H. Meibom pro- duced in 1639 a work ” Von der Niitzlichkeit der Geisselhiebe in medizinischer und physischer Beziehung.” Another curiosity from this time
    is the well-known “
    Flagellum-Salutis

    (1698), in which Paullini praises
    massage for many things, but especially for pleasure. Paullini was a
    poet, that is to say, and it is to be hoped that the services he rendered to poetry were greater than those to mechano-therapy. He takes up anextremely naive standpoint, and is one of the first in the wearisome list of uncritical dreamers who regard massage (with him equivalent to
    tapotement) as being able to cure all possible complaints, not excepting
    syphilis.
    Between the seventeenth and eighteenth centuries we come across a
    great German name, Friedrich Hoffmann (16901742,

    Dissertationes
    physicomedicac,” Halle, 1708). Hoffmann pronounces gymnastics to bethe best form of remedy, owing to its influence on the circulation, appetite and general condition, etc., and also discusses massage, following
    the example of Hippocrates, Celsus and Galen. There is no doubt that
    he contributed in a marked degree to the development of mechanotherapy in Germany, England and France during the eighteenth century.
    In Germany, in the earlier part of the century, we find the smaller works
    INTRODUCTION. 5
    of Stahl, Wedel, Albert! and Buchner, in 1748 Boerner’s “
    Dissertatio
    de arte Gymnastica
    ” and Gehrike’s ” De Gymnasticsc medicfc veteris inventoribus ” were printed in Helmstadt, and in 1749 Quellmatz’s ” Programma de frictione abdominis “
    in Leipzig. In England we find a work ” Medicina Gymnastica, or Treatise Concerning the Power of
    Exercises

    ; in Scotland (1788), a treatise ” De Exercitatione,” by
    Sherlock. In France mechano-therapy had a period of real prosperity.
    Andry, in 1741, printed in Paris his remarkable “
    Orthopaedics

    ; Winslow, also a well-known Parisian doctor, employed mechanical
    treatment for deformities (Dally) ; Rousseau recommended brisk exercise and gave a strong impulse to educational gymnastics ; the renowned
    Tissot (a Swiss) wrote his ” Gymnastique medico-chirurgicale

    (Paris,
    1780), and therein discussed massage in detail (” wet “
    or
    ” dry,” with
    weak, medium, or strong friction). Dr. Tronchin of Paris, a man in high
    general esteem, used gymnastics and massage assiduously in his enormous
    practice. These were both in fashion at that time in the French capital.
    Towards the end of the eighteenth century there was a great development of gymnastic activity in Germany, but practically only in educational gymnastics. From 1770, it may be reckoned, many became instru- mental in spreading it in schools, till its use became general all over Germany. I remember in this connection the well-known names of
    Frank, Basedow, Salzmann, Guthsmuths, Viehy, Pestalozzi, Jahn.
    Eiselen, Massmann, Lorinser, Spiess, and others whose work belongs
    partly to our own century. In literature Guthsmuths is the best known
    of the German authors, and one comes across his work,
    ” Die Gymnastik
    der Jugend
    ” (Schnepfenthal, 1793), here and there in book collections. One notices markedly the influence of the ancient writers and also of
    Friedrich Hoffmann. Guthsmuths speaks in detail and intelligently of some of the effects of gymnastics, emphasises the necessity for developing
    the different muscle groups harmoniously, and mentions active and
    passive movements. In the end of his work he shows the ease with
    which one may, with the help of an anatomical atlas and a skilful doctor,
    work out a scientific gymnastic system, and gives the outline of such a
    system. Although the real value of massage was recognised by many
    long before this time, it seems to have lain outside Guthsmuths’ thought
    and experience.
    It may be appropriate to pause here to remind ourselves of the great
    activity of practical and theoretical medico-mechanics, both in regard to gymnastics and massage, towards the end of the eighteenth century,
    and especially to remember that when Tissot wrote his famous work in 1780 the so-called Swedish medical gymnastics did not exist, and that
    Per Henrik Ling, who later rendered his fatherland and all mankind
    such great (though uncritically and ignorantly estimated) service in
    this direction, was then only four years old. Meanwhile we must remember that massage, in the end of the
    eighteenth and beginning of the nineteenth centuries, was nowhere deeply
    rooted either in England or on the continent of Europe. In France
    especially, although it was practised by several doctors prominently
    represented in literature, it seems, after a rise of rather short duration
    in the end of the eighteenth century, to have sunk into discredit or been
    6 MASSAGE AND GYMNASTICS.
    forgotten in the beginning of the nineteenth. For example, Londe(” Gymnastique Medicale,” Paris, 1820, pp. 249 255) speaks of “
    fric- tions et onctions, le massage et le massement,” disapproves of “onctions,”
    and mentions frictions as “
    useful for people who take no exercise, also
    in some diseases,” of which, however, not a word is said. They are
    especially good for people
    ” who live in northern, marshy countries, and
    for those weakly children with fair hair, blue eyes and large heavy
    abdomen, who are so sluggish physically and intellectually.” Hefurther thinks he has heard of massage in Tahiti, considers it tonic, but
    accuses it of encouraging sensual sensations. This is amusing, but it is still more amusing that on this account Hiinerfauth, in his ” Handbuchder Massage,” gives as his verdict that Londe has written of massage
    that it is “
    ziemlich erschopfend.”
    Swedish traditions on mechano-therapy begin with Per Henrik Ling
    (1776 1839). Ling made his appearance as early as 1805 as a gymnastic
    and fencing teacher in Lund ; in 1813 he founded the ” Central Institute
    of Gymnastics

    in Stockholm and remained a teacher there until his death. His chief work,
    ” On the General Principles of Gymnastics,” came out first in 1840 after his death. Since he is much talked of but
    really very little known, and since, as a fellow-countryman, he specially
    interests the readers of the Swedish edition of this work, I will discuss
    somewhat in detail the significance of his work in regard to mechanotherapy.
    The Ling system of gymnastics, in contrast to the German system, was
    chiefly therapeutic (” medical gymnastics “), although Ling to a great extent looked after the interests of educational gymnastics. He arranged a great many movements, which, according to ancient custom, he
    divided into passive, active and duplicated. It is less known, but of more
    interest to us and a greater service on Ling’s part, that he was familiar
    with massage, the manipulations of which (” friction, hacking, pinching,
    squeezing, kneading,” /. c., p. 581) he classes as passive gymnastic movements. Massage forms a very important part -of the Ling system of ” medical gymnastics
    ” and is used in many forms. Ling mentions
    (p. 530) neck massage, which he recommends for headache and giddiness, was familiar with ” abdominal kneading,” and made use of both local and general massage with almost the same technique as is now used bySwedish doctors and by all the so-called Mezger’s school. Leaving out
    the noisy advertising and “
    puffing “
    of Swedish gymnastics by Ling’s
    followers, it was chiefly massage which gained for this form of therapy
    the prestige it has won. Moreover, among the workers trained by the
    Central and other institutes, massage forms a more important and essential part of their work, both for themselves and their patients, than gymnastics. It is worth noting that Ling himself included massage manipulations among passive gymnastic movements, and that the Swedish
    gymnasts, partly in reverence for their idol, partly from a practical
    motive, have done their utmost to eradicate the term ” massage
    ” and
    to represent the use of movable pressure on the soft parts as a special
    part of gymnastics.
    By his own practical work and also by his own creation, the ” Central
    Institute of Gymnastics
    ” (notwithstanding its later vagaries), Ling
    INTRODUCTION. 7
    exercised a great influence on the position of massage and medical
    gymnastics in and beyond Sweden.
    At the same time, he has performed a very important life work by
    contributing in a high degree to the development of Swedish sport.
    This he did by educational gymnastics, and by different exercises (” the
    horse,” ” the boom,”

    the ropes,” fencing).
    And lastly I would lay stress on a very great service Ling rendered.
    lie himself clearly saw and often expressed his opinion (as I and others
    have heard from conversation with the well-known Major Thure Brandt) on the necessity of his treatment being under the control of doctors. In
    contrast to many of his followers, he was an unpretentious worker at mechano-therapy, devoted to his life’s work and entirely opposed to advertisement,

    business,” and the seeking of a monopoly. We have, therefore, every right, on account of Ling’s character and of
    his important life work, apart from his very good work as a poet, to include him in the number of our really great men. His worth is not
    diminished either by the fact that his work has been partly spoiled by
    others, or that he himself has been indiscriminately praised, widely
    advertised, and painted in false colours.
    It is not Ling’s fault that his picture has been made to serve as a signboard for that market where Swedish gymnastics has been offered for
    sale with drums and trumpets, with charlatan clamour and brag, and
    with crude ignorance and naivete. Unfortunately, Ling has been repre- sented not only as the devoted, honourable, modest, industrious, and
    talented worker in the service of mankind which he really was, but also,
    what he certainly was not, as an epoch-making discoverer of a method
    of treatment which only his own school is able to carry out. We have
    already seen that both massage and gymnastics, long before the beginning of the nineteenth century, were so generally used and in all essentials so much developed that no very great

    originality,” nor the services of a

    discoverer,” were necessary to bring this simple method of treatment
    into use. All that Ling used had for long been in use, with the exception
    of some special movements, which, as Guthsmuths had already pointed
    out, were easy to arrange. It is certain from Ling’s own writings that
    he knew the ancient European mechano-therapy. It would be an
    absurdity to assume that he did not know the French “
    medico-chirurgical
    gymnastics,” in which massage was included or German gymnastics,
    which began to flourish during his youth and which, in spite of his criticism of it, had a great influence on his own work. For those who will not claim for their own nation more than justly belongs to it, it is not
    too far-fetched to consider that Swedish medical gymnastics is the
    offspring of German and French parents, although the child certainly
    attained stronger vitality than either of its parents.
    Nor can it be denied that Ling’s ignorance of medicine and the subjects
    connected with it, along with a certain want of clearness and tendency
    to mysticism, had a detrimental influence on his work. He was able
    with his conscientiousness, enthusiasm and energy to obtain good
    therapeutic results and to spread his treatment far and wide. But he was not able to establish it on a scientific basis and to develop it. To
    make clear the physiological and therapeutic effects of mechanical
    8 MASSAGE AND GYMNASTICS.
    treatment, to set forth and limit its indications, was not within Ling’s
    power, and his own representations of these things were extremely
    fantastic. In his work he tried to replace knowledge of the facts relating to it by purely speculative subtleties, none of which have any independent merit. The writings of this man, in many ways so eminent, do
    not therefore stand ahead of his time, but even contrast unfavourably
    with those of many earlier writers.* Some short extracts from Ling’s work,
    ” On the General Principles of
    Gymnastics,” should give the reader a good idea of his standpoint. The
    book is divided into six parts which treat of (1) the laws of the human
    organism ; (2, 3, 4, 5) the principles of educational, military, medical and
    aesthetic gymnastics ; and (6) gymnastic apparatus. The first division contains what Ling certainly considered a complete philosophic system,
    in which three primitive forms of vital force play the chief part. These
    arc (p. 444) ” the dynamic, in which life, as if expressing its independent
    existence, tries to free itself from matter, chemical and mechanical, by
    which life in combination with matter manifests itself ; yet it seems that
    life is more evident in chemical power, matter in mechanical, so that
    both of these may be considered forms of it under different conditions.”
    The dynamic form corresponds in the organism to the nervous system,
    the chemical to the circulatory, the mechanical to the muscular system.
    Mutual harmony between these three ” agents

    constitutes health. When the harmony is disturbed illness arises in such a way that ” when
    the dynamic form is the chief agent, illness arises in the mechanical
    form ; when the mechanical is most active, the illness takes the chemical
    guise ; and when the chemical is the chief agent, the illness shows itself in dynamic power

    (p. 523). Ling did not here feel himself to be on
    certain ground, but remarks that when so many learned men have made
    mistakes in this region his opinion, too, must be carefully revised ” where
    necessary.”
    Ling reasons widely about the fundamental forms of life and their connection with diseases and their symptoms.
    ” A disease, as cause, generally belongs to, and also manifests its sign in, one fundamental
    form, although the latter may not be the same as the former ; we call this a one-symptomed disease. But if the cause of disease belongs to one
    of the fundamentmal forms, and its signs are manifested in the two other, or even three other fundamental forms, we call it many-symptomed

    (pp. 519 520). Concerning these distressing many-symptomed diseases
  • Ling had a manly, independent and warm-hearted personality, and won in a high
    degree the affection and esteem of his pupils. These feelings have been inherited by the
    present generation of Swedish gymnasts, who often regard Ling with an admiration which
    excludes all criticism. It is both touching and amusing to see with what reverence these gentlemen receive the greatest oddities that flowed from Ling’s pen. This reverence is only increased by the fact that they, pardonably enough, do not in the least understand what their idol means, and they remind one very strongly of Peer Gynt on hearing Begriffenfelt’s profundities : “
    Truly an extremely gifted man ! Almost all he says is beyond one’s understanding.” Ling’s reputation for those qualities which he lacked has spread meanwhile in certain circles far beyond Sweden. For example, many years ago I came across a good-natured Spaniard (Busque y Torro in “
    Gimnastico higienica, medica y ortho- pedica,” Madrid, 1856), who calls him ” hombre erudite, de vastos conocimentos y de
    solida instruccion.” For my part, I believe that in estimating Ling, or any one else, one does best by seeing things as they are, and I have written of him as I have done, not with a view to lower a deservedly distinguished name, but because I think a more moderate
    estimation of him in certain directions may render a service to physical therapeutics.
    INTRODUCTION. 9
    Ling sagely remarks that “
    it is generally safest to use mechanical treat- ment last, and to employ chemical while the patient is weakest.”
    Ling, as was a priori to be expected, and as far as one can decide from
    his indefinite statements, assigns to mechano-therapy all that belongs
    to it and a good deal more, but in this respect nevertheless he is wiser
    than many modern gymnasts. He specially excepts from mechanical
    treatment all febrile illnesses, concerning which he fortunately held the
    opinion that “
    the mechanical agent is strong in these, the chemical
    apparently deficient “
    (p. 542). On the other hand, he considers scabies
    suitable for treatment (apparently being ignorant of its parasitic nature,
    although it had been proved long before his time). This disease depends
    mainly on
    ” an excess of the internal chemical agent,” and can therefore be removed by means of movements, i.e., by increasing the mechanical
    agent. Ling saw seventy to eighty persons affected by itch cured in this way, and advises, presumably with the support of the experience he
    gained by this remarkable chance, ” beginning treatment by preparatory
    movements, and by degrees going on to complete active gymnastics

    (p. 540).
    Ling loves symbols and metaphors. So he gives us amongst other
    things the interesting information that the thumb denotes constancy and
    precision, that the forefinger is instructive, that the middle finger
    expresses calmness and sense, the little finger ease and grace. Even
    Ling’s fancy seems to fall short in assigning a
    ” part

    to the ring finger,
    and he therefore with praiseworthy presence of mind confines himself
    to the remark that this finger is seldom used alone. Ling’s system of medical gymnastics was developed and promoted in Sweden by his pupils, Branting, Hjalmar Ling and others, and was
    studied also by several doctors, especially Sonden and Liedbeck. Abroad,
    Swedes and others were active in the same direction Georgii in Paris,
    Eckhard, Schmidt, Rothstein, Eulenberg and Neumann in Germany,
    Melicher in Austria, Indebetou and Roth in England, Eichwald, dc
    Ron and Berglind in Russia.
    The three Prussians, Rothstein, Neumann and Eulenberg,* are the
    best known. Rothstein had not a medical education, and his work, which was important from a practical point of view, suffers as to its theory
    from this want. Neumann was a doctor, but belongs to that lamentable
    type which, in view of the frequent brilliant results of mechano-therapy,
    loses all critical sense and works in season and out of season on behalf
    of this treatment, which he plainly declares offers a prospect of true reform in the treatment of all chronic diseases. There is no doubt that
    he very much damaged his cause. After perusing his two bulky volumes
    almost with horror, it was refreshing to read Eulenberg’s essay on
    Swedish gymnastics, bearing witness to his medical culture, temperate
    understanding and scientific way of thinking.
    During the first half of the nineteenth century we see no essential advance in Ling’s physical therapy anywhere. In France this treat-
  • Rothstein wrote, amongst other tilings, ” Die Gymnastik nach dem System des Swedischen Gymnasiarchen Ling,” Berlin, 1848 1859, and (along with Neumann) a
    journal ” Athenaeum fur rationelle Gymnastik.” Neumann produced
    ” Heilgymnastik
    oder die Kunst der Leibesiibungen,” Berlin, 1852. Eulenberg, amongst other things, ” Die schwedische Heilgymnastik,” Berlin, 1883.
    10 MASSAGE AND GYMNASTICS.
    ment seems to have declined after its short flourishing period in the
    eighteenth century ; I have already mentioned the negative standpoint
    of Londe (1820) regarding massage. In Germany and in the Scandinavian countries gymnasts were at work in a more or less rational way,
    and massage on the whole was somewhat neglected. Lastly, in England,
    where sport partly fulfilled the aims of gymnastics, physical therapy
    gained no great ground, although we have some noteworthy works * which show that it was alive, and although, as already mentioned, two
    of Ling’s pupils practised there. The new era for massage began in the middle of the century, and its history, like that of medicine, gives one the same impression, that all that has been gained has, to a great extent, been gained since that time.
    It had hitherto been considered by few doctors, but had been mainly
    in the hands of individuals who could not themselves estimate its importance nor introduce it into the world of learning. Now it was more
    generally adopted in the service of science. A beginning in this direction was made in France, where one often
    finds good initiative power (with some lack of perseverance). In the
    fifties the mechanical treatment of chorea, which had been tried there
    for a decade, became more and more general. Bonnet, who in his previous work is indifferent to such treatment, in his classical “
    Traite dc
    thcrapeutique des maladies articulaires,” published in 1853, warmly
    recommends gymnastics and massage in various joint affections. Lastly,
    Daily’s and Laisnc’s well-known works were written about this time.
    But it was the Germanic peoples (and especially the Germans) whorendered the greatest services in this as in so many other directions. Astrong impulse was undeniably given by the well-known Dr. Mezger, of
    Amsterdam, who worked as a masseur from the beginning of the sixties,
    and who in an almost unheard-of degree had the power of winning
    general confidence, and also had, through his German and Scandinavian
    pupils, a very great influence on the position of massage in the medical
    world. The formerly despised method of treatment was taken more and more under the protection of some of the most prominent heads of the
    great German and Austrian clinics, and was used by doctors whose names ennobled their method of treatment. When Langenbeck and
    Billroth pointed out the importance of massage ; when later Hueter,
    Esmarch, Barbieri, Volkmann, Gussenbauer, and many others began
    to use it ; and when its effects were scientifically demonstrated by them
    and others, people in Germany and Austria began to see that massage
    and medical gymnastics had the same claim to be examined as other
    branches of mechano-therapy, or as treatment by chemical, thermal,
    electrical and other means, and that the fact that they had been muchmisused and advertised by charlatans could equally little lower or raise their real worth. In the north, especially in Sweden, which since Ling’s
  • ” The Muscular Motions of the Human Body,” by Dr. John Barclay, Edinburgh,

  1. Illustrations on the Power of Compression and Percussion on Rheumatic Gout
    and Debility of the Extremities,” by Dr. Balfour, Edinburgh, 1809. ” A Full Account of the System of Frictions as adapted and pursued with the greatest success in cases of Contracted Joints and Lameness from various causes, by the late eminent surgeon, John
    Grosvenor, Esq., of Oxford,” by William Cleobury, 1825. “
    Therapeutic Manipulations
    or Medical Mechanics,” London, 1840, by Ling’s Swedish pupil, Indebetou.