The Manual of Massage and Movement (1938)
Edith Prosser, Manual of Massage and Movements (London: Faber and Faber, 1938)
The Manual of Massage and Movement first published in 1938 and released in four subsequent editions, was a textbook intended for students of ‘massage’ or what we would now consider to be physiotherapy. The book’s author Edith Prosser was a trained nurse, certified midwife, the Sister in charge of the Massage Department of the Middlesex Hospital and a leading council member of the Chartered Society of Massage and Medical Gymnastics (CSMMG), and therefore deemed an authority in the field. Prosser also wrote another textbook for physiotherapy students Bandaging and Simple Nursing Notes for Massage Students which was published in 1940.
The origins of the physiotherapy profession in Britain are frequently traced to the formation of the Society of Trained Masseuses (STM) in 1895. In the late-nineteenth century there was a dramatic revival in the use of massage for remedial purposes; it was deployed by the medical profession for a range of conditions ranging from nervous disorders such as neurasthenia and hysterical paralysis; medical complaints such as poor circulation and constipation to disabilities such as scoliosis and flat foot. This popular revival had an interesting side effect, however, and ‘massage parlours’ soon proliferated across London as a disguise for brothels, which were outlawed in the 1888 Criminal Law Amendment Act. This state of affairs erupted into the national press in the summer of 1894 in a series of ‘massage scandals’ decrying the massage craze as a cloak for immorality. The STM formed in response to these scandals; they were a small group of elite nurses and midwives who practised massage as a routine part of their work and sought to professionalise massage to make it a ‘safe, clean and honourable profession for British women’. Since its inception, the STM has remained the central representative body for physiotherapy, evolving into the Incorporated Society of Trained Masseuses (ISTM) in 1900, the Chartered Society of Massage and Remedial Gymnatics (CSMRG) in 1920, and the Chartered Society of Physiotherapy (CSP) in 1944. The history of this professional body has been documented by two authors Jane Wicksteed (1948) and Jean Barclay (1994).
One strategy that the STM deployed to professionalise massage was to organise regular examinations in the theory and practice of massage and form a register of certified masseuses. By 1938 when the Manual of Massage was published the Society not only examined students in massage and remedial exercises but also actinotherapy (light treatment), electrotherapy and hydrotherapy reflecting the development of massage to physiotherapy.
The Manual of Massage is an example of a textbook for students learning the theory of massage and medical gymnastics and intending to enter the Society’s examination. While the text details anatomy and physiology as far as possible, Prosser notes that relatively little was scientifically understood about the physiological effects of massage in 1938. This highlights that throughout the First and Second World Wars evidence for physiotherapy remained largely empirical and anecdotal - reliant upon visible effects and patient responses – and many remained sceptical towards its ‘scientific status’ and therapeutic value. What separated ‘professional’ massage from ‘unintelligent rubbing’, Prosser argued, was that the trained masseuse thoroughly understood how the ‘dosage’ and ‘technique’ of massage should be progressed according to the individual patient, a competency proven by passing the Society’s examination.
The Manual of Massage includes 24 chapters. The first half of the text instructs students in the method of massage and remedial exercises, describing manipulations such as ‘effleurage’, ‘stroking’, ‘kneading’ and ‘vibration’, as well as ‘passive’ and ‘active’ movements. The text also details how to apply massage and exercise to the body to treat certain conditions, with chapters including ‘Massage for the neck, chest, abdomen, head and face’, and exercises prescribed for joints and spinal deformities. Instructions are accompanied with match figures to illustrate how to position the patient and administer the movements and manipulations.
The Manual of Massage was not an isolated textbook and a browse in the Wellcome Library catalogue highlights that many were written on the topic in the late-nineteenth and twentieth centuries. While some of these were produced by masseuses such as Prosser and Margaret Palmer specifically for students, many were also written by medical men such as Emil Kleen and James Mennell who were interested in promoting the emergent field of physical medicine for their own professional advancement.
The Manual of Massage and Movement, then, offers valuable insight into far more than simply how to do massage. It offers a lens through which to explore history of physiotherapy, the professionalisation strategies of aspirant nurse-masseuses and medical men, as well as changing responses within society and medicine towards rehabilitating physical disabilities and women’s work.
Looking for more sources?
The Hypatia collection includes a number of interesting items relating to the female healthcare professions such as nursing and occupational therapy. Material ranges from Florence Nightingale’s famous Notes on Nursing of the 1860s, to reports from the World Health Organisation on nursing care for the elderly and handbook’s for occupational therapy in rehabilitation, in the 1970s.
Related to the history of massage more specifically, the Devon and Exeter Institute holds an interesting example by A Symons Eccles, The Practice of Massage: Its Physiological Effects and Therapeutic Uses (Bailliere, 1898), which demonstrates the process of medicalisation ‘in-action’. Many more examples of how the traditionally lay practice of massage was translated into orthodox medical discourse can be found at the Wellcome Library – much of which has been digitalised and available online.
Written by Dr Kay Nias