What Is Massage?

Many definitions of massage can be found in the literature and regulatory archives of modern times, but there is no known definition of massage from the ancient world. Gertrude Beard and Elizabeth Wood, professors of physical medicine at Northwestern University Medical School and authors of the well-known book Massage: Principles and Techniques (1964), assert that "the early medical literature is devoid of any comprehensive definition of massage." They also claim that ?there is little description of massage movements in the early literature." However, Hippocrates (460-377 B.C.E.), widely regarded as the father of medicine and a renowned advocate of massage, wrote about the use of friction in the treatment of many ailments, as well as about its physiological effects: "Rubbing has the effect of relaxing, constricting, thickening, and thinning; hard rubbing constricts, soft relaxes, much rubbing thins, and moderate thickens." The ancient Greeks used techniques that they called anatripsis and frictio. The word anatripsis - meaning "to rub up" - represents a transitional period in the history of massage (see Pages From History, "Rubbing up vs. Rubbing Down.")

Greek physicians performed anatripsis on patients suffering from intestinal ailments and on athletes suffering from waste buildup in their muscles. Today we use anatripsis in much the same way, even though we have our own word for it and have developed more techniques and better rationale to describe its effects. The ancient physician Claudius Galenus, commonly known as Galen (131-201 C.E.), was a strong proponent of the Hippocratic method. In his extensive writings about massage he did not provide a definition; however, in his De Saniotate Tuenda (Hygiene) he did give descriptions of massage from which we might draw elements of a definition. He wrote that the objective is "to soften the body" before exercise. "And the rubbings should be of many sorts, with strokes and circuits [sic] of the hands, carrying them not only from above down and from below up, but also subvertically, obliquely, transversely, and subtransversely." He goes on to give more details about how the hands should move "from every direction."

From these instructions we can conclude that massage as practiced by the Greeks was a manual treatment of the body utilizing a variety of hand techniques. There are also references to utilizing cloth and water during the rubbings which expand the definition from the ancient to include the use of tools and mediums other than the human hands. The descriptions of massage have changed between the time of the ancient physician and the modern practitioner, but the essence of massage has remained unchanged - the application of human hands or another object to the superficial skin of a recipient for the purposes of rendering remedial or palliative aid.

Although positive references to the healing power of touch can be found in historical documents in many fields, the first lucid descriptions of the movements of massage, such as friction and rubbing, were given by the French physician Joseph-Clement Tissot. Writing in his 1770 classic text on exercise, Tissot devotes more than 20 pages to the subject of "friction, rubbing, kneading and alternate compressions." He does not use the word massage because the word had not yet been created. Even so, Tissot expounds on the ancient virtues and modern benefits of the movements that make up, in large part, what we now know as massage.

During the latter half of the 19th century medical doctors in Europe and America began writing about the benefits of massage. As more physicians were introduced to the domain of manual therapeutics the terminology of the practice began to change, reflecting the physicians’ disdain for common massage; the commonly used terms were gradually replaced by more medically oriented terms. For example, rubbing, a term used in 1866 by Walter Johnson, became medical rubbings by the 1880s. By the turn of the century medical rubbing was replaced by Massage with a capital M. The distinction between massage with a little m and Massage with a big M reflects the physicians’ dislike of gymnasts, or "common rubbers" as they were called. The doctors argued that the massage done by gymnasts did not have the credibility of the massage used medically because only someone trained and/or supervised by a physician could be considered properly doing massage.

Thomas’s Medical Dictionary of 1886 defines massage in this terse way: "Massage, from the Greek, meaning to knead. Signifying the act of shampooing." There is evidence in other historical texts that shampooing initially meant massaging or rubbing; only later did it come to mean cleaning the hair with special products.

George H. Taylor, M.D., in his 1887 book, Massage: Principles and Practice of Remedial Treatment by Imparted Motion, writes: "The word massage denotes any process of conjoint motion and pressure applied to parts of the living body, for remedial purposes. Massage implies some source from which the pressure-motion is derived arising from insufficient muscular action of the usual forms."

Taylor was very concerned in his book with what he called "motor-energy," derived from "nutrition" and responsible for all motion or power of the body. "The motor power of the human hand," he affirms, "easily lends itself to this generous purpose; and it thus, almost by instinct, but in strict conformity with scientific principles and purposes, reinforces the vital needs and waning energies of the suffering."

Douglas Graham, M.D., American Medical Association member and author of Manual Therapeutics, A Treatise on Massage (1890), defines massage in this way: "Massage is a term now generally accepted by European and American physicians to signify a group of procedures which are best done with the hands, such as friction, kneading, manipulating, rolling, and percussion of the external tissues of the body in a variety of ways, either with a curative, palliative or hygienic object in view."

Although not specified in most definitions, these early authors also limited massage movements to those performed solely by the hands, often as an adjunct to other therapies in the treatment of disease. In his 1895 book, The Art of Massage, John Harvey Kellogg, M.D., of the Battle Creek Sanitarium, states, "Massage, or systematic rubbing and manipulation of the tissues of the body, is probably one of the oldest of all means used for the relief of bodily infirmities." He also provides several terms related to the word massage, as well as their "right and proper" pronunciations: Massage is a noun, the literal meaning of which is kneading, as a baker kneads bread. This word, like many other terms relating to massage, is derived directly from the French. It retains its French pronunciation, and is pronounced as though spelled mas-sahzh, and not as though spelled massaj or massaje, which is so frequently heard.

Masser is a verb, meaning the act of applying massage.

Pe’trissage is pronounced as though spelled pa-tris-sahzh. It is a French term applied to deep kneading, as distinguished from superficial kneading.

Tapotement is pronounced nearly as though spelled tah-pote-mont, and indicates the act of percussion.

Effleurage is pronounced as though spelled ef-flur-ahze. It means light friction.

Noah Webster’s 1899 An American Dictionary of the English Language does not contain the word massage. It does define friction first as the act of rubbing two objects together to produce heat; second, as the scientific meaning of mechanical rubbing of two moving objects; and third, "In medicine, the rubbing of the body with the hand, or with a brush, flannel, etc., or the rubbing of a diseased part with oil, unguent, or other medicament.? Rub is also referred to as ?the act of rubbing, friction."

Axel V. Grafstrom, M.D., in his 1904 book, A Text-book of Mechano-Therapy, writes, "By massage we understand a series of passive movements on the patient’s body, performed by the operator for the purpose of aiding nature to restore health. These passive movements are friction, kneading, percussion, stretching, pressure, vibration, and stroking." Grafstrom used bold test in his book to assist students in finding key words for their studies.

Emil G. Kleen, M.D., of Sweden, a contemporary of Graham, defines massage in his 1921 edition of Massage and Medical Gymnastics as "a manipulation or handling of the soft tissues by movable pressure in the form of stroking, rubbing, pinching, kneading or beating performed with a therapeutic aim. This is generally applied by hand, but can, of course, also be given by means of instruments and apparatus of different kinds."

Thomas Stedman, M.D.’s 1936 edition of A Practical Medical Dictionary defines massage as "a scientific method of manipulation of the body by rubbing, pinching, kneading, tapping, etc.; it is employed in therapeutics to increase metabolism, promote absorption, stretch adhesions, etc."

And finally, a typical late 20th century dictionary defines massage as "act or art of treating the body by rubbing, kneading, or the like, to stimulate circulation, increase suppleness, etc."

We can see from these definitions a clear transition of terms and descriptions from the earlier examples. Even though the definitions become more succinct, they are broader in scope and in the end also provide examples of the benefits of massage.

Contemporary definitions of massage in the new textbooks seem to take a different course than historic definitions by extended definitions that attempt to include all manner of techniques and applications, as well as a growing list of effects. But none of the definitions found in regulations or textbooks provide a comprehensive historic definition of massage, nor do they include the indirect effects.

Massage: From the Greek word massein (to knead). The manipulation of the body by kneading, stroking, friction, percussion, vibration and other methods applied with the hands, feet, elbows, forearms, or with tools such as stone, wood, ceramic, ivory, metal, bone, or devices that operate by hand-crank, steam, battery or electric power; and the use of water, herbs, salts and muds, any and all of which may produce directly or indirectly various therapeutic effects, feelings of pleasure or pain, a sense of being nurtured and supported, an uplift of the spirit, and general well-being. Massage may also be applied adjunctively with other therapeutic measures such as physical therapy, dentistry, chiropractic and any stress- management regimen.

Robert Noah Calvert is the founder and CEO of Massage Magazine. The material for this column comes from the World of Massage Museum's collection and Calvert's book, The History of Massage, published in February 2002 by Healing Arts Press.