cover story
From Quackery
to Qualification
4
massage australia
Massage in Australia,
1870 - 1914
Massage therapy - quackery or legitimate medical
practice? This was the question on everyone’s lips
in Australia in the late 19th and early 20th centuries.
How was the stigma and hostility directed towards
our profession by the orthodox medical profession
overcome to such an extent that, by the turn of the
century, massage therapists were accepted by and
working with their medical colleagues?
BY PHILIPPA MARTYR PhD
P
hilippa Martyr PhD, is a historian who
has been researching the history
of Australian medicine and health
care for nearly twenty years. In the past,
she has taught at the University of Western
Australia and the University of Tasmania.
She is currently working at the Centre for
Clinical Research in Neuropsychiatry at
Graylands Hospital, Perth, WA and is also
researching the history of the Claremont
Mental Hospital (1903-1972).
Dr Martyr wrote ‘From quackery
to qualification’ when she was working
at the University of Tasmania. It came
out of her PhD research into the history
of rehabilitation in Australia, which
included the history of physiotherapy and
its professional organization. She was
fascinated by the way in which a therapy
could slowly transpose from its position
outside ‘normal’ medical practice to the
mainstream and become widely accepted
as a profession. It also led her to write her
book, Paradise of Quacks: an alternative
history of medicine in Australia (2002).
From Quackery to Qualification:
Massage in Australia, 1870-1914
Dr P J Martyr
The two main unorthodox contributors
to the development of rehabilitative
practices before the Great War were
electrotherapy and massage. These were
only two of the many healing therapies
available to the public, without medical
referral, in the major population centres in
massage australia
5
cover story
Above. IMAGE COURTESY OF THE STATE LIBRARY OF SOUTH AUSTRALIA. SLSA: B 26285/215 ­ Keswick Hospital: Treatment, ca. 1918.
Australia. Electrotherapy, on the one hand,
failed to establish a lasting identity as a
profession.
Massage, on the other hand, advanced
towards recognition as a profession through
skilful association with medical practitioners.
By accepting a prescribed, subordinate
and largely gendered relationship to
orthodox medicine and its practitioners,
massage escaped the stigma attendant on
and hostility directed towards ‘quackery’
by the orthodox profession. This article
will attempt to trace the development of
this intricate relationship through to the
emergence of the Australian Massage
Association under medical patronage, in
1906.
Massage and Orthodox Medicine
Dr Louis Henry, discussing massage
in the Australian Medical Journal in 1884,
described its aims:
“The principle of massage is entirely
opposed to our traditions of rest to every
inflamed part, and consists of a combination
of procedures which are intended to rouse
distorted and passive parts into a natural
6
massage australia
condition of activity and health, and largely
by the removal of abnormal deposits by
mechanical means.” (Henry, 1883 pp 337- 8)
Massage can be seen as part of a
general movement within British medicine
towards ‘physical culture’, a concept tied
up with fears of racial degeneration and
new ideas about social hygiene. It is worth
noting, too, that massage appears to have
been preferred as a form of actual medical
treatment, rather than as part of postsurgical care. The move from medicine to
surgery may have in some ways limited
the wider uses of massage as medical
treatment, creating instead a dependence
on physicians and surgeons for referrals.
What is interesting about this shift is
that the sacrifice of wider applications
of massage may have been seen as a
price worth paying to achieve medical
recognition and legitimacy. (Martyr, 1997)
The Australian Medical Journal in
1879 recommended to its readers the
ladies’ gymnastics school run by Misses
Dick and Moon, and confirmed their
recommendation three years later. Miss
Dick had gone through the “professional
training” necessary to qualify her as a
teacher of gymnastic exercises and their
“intelligent application”, whereas Miss
Moon’s qualifications were that she was the
daughter of a doctor and willing to work
under medical supervision and authority.
Their school was recommended as:
“an establishment to which the profession
may confidentially send such of their ladypatients as require the well-considered
application of the sort of exercise that
is necessary for the recovery of muscles
[wasted by disease or sickness].” (AMJ,
1879)
Early information on massage treatment
was available to orthodox practitioners
in Australia in the 1880’s from the British
Medical Journal. In 1884, Dr Zubelndowsky
of Berlin reported to the International
Medical Congress held in Copenhagen that
year, that “massage should form an integral
part of the after-treatment of traumatic
injuries of greater or less extent.” (BMJ,
1884, p 425) Dr W Murrell, of Westminster
Hospital, indicated in 1886 the role of the
masseuse in treatment:
“On the continent the physician or
surgeon is usually his own operator, it being
considered inexpedient (not suitable) to
employ, even as an assistant, anyone who
has not been thoroughly and systematically
trained, a process which requires, at least,
two years of unremitting attention. It is
known that, in many instances, incalculable
harm has resulted to patients from
ill-directed efforts.... An accomplished
masseuse is essential; but she must be
well educated, and should have such a
knowledge of anatomy and physiology as
will enable her to carry out the instructions
of the physician intelligently.... Aptitude is
of more importance than mere muscular
strength. (Murrell, 1886, p 926)
The and again throughout the 1880s in
the British Medical Journal. (Martyr, 1997) In
one of the more weighty articles appearing
on massage in the Australian Medical
Journal, Dr Louis Henry claimed that:
“Its usefulness is the most recognised
where it is intelligently combined with
galvano-therapeutics and suitable
regimen.... When the general practitioner
becomes more familiar with its methods, it
will take a prominent place in our every-day
therapeutics.” (Henry, op cit, p 347)
As with electrotherapy, it was the rule
rather than the exception that medical
practitioners applied massage as a form of
treatment to their patients. This gradually
changed in the 1890’s. Dr J Hamilton,
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7
Above. IMAGE COURTESY OF THE STATE LIBRARY OF VICTORIA, Massage, electricity and gymnastics for ladies and children Madame Tait, T.M. Donaldson & Co., North Brighton [Vic] : 4 April 1891.
addressing the Intercolonial Medical
Congress of Australasia in 1892 on the
subject of spinal curvature, pointed out that:
“No doubt the carrying out of
these [remedial] exercises would be a
considerable tax on the time of busy
general practitioners, but most of them
might be carried out by trained assistants
under his supervision, just as massage is
done.” (Hamilton, 1892)
Massage treatment was generally
classified into four types of application. The
first of these was the centripetal stroke,
otherwise known as effleurage or friction
douce, directing all strokes to the centre
of the body or the heart. Massage friction
involved one hand performing centripetal
massage while the other disseminated the
Doctors using massage treatment
appeared to associate readily with nonmedical ancillaries.
build up of pressure, and was considered
a more difficult technique. (Henry, op cit)
Pétrisage was kneading or squeezing,
raising the muscles and soft tissue, and
tapotement involved quick and sharp
successive strokes applied with the margin
of the hand. The very nomenclature of
massage was rife with erotic associations,
presenting a strong contrast to the
customary Latinisms of medical language.
Perhaps for this reason, English-speaking
doctors felt called upon to insist heavily
upon its impeccable respectability in history.
And massage could be made to present a
respectable pedigree. Articles by orthodox
practitioners tended to endow massage
with illustrious ancestry, comparable to the
connection between their own activities and
the healing arts of Hippocrates and Paré.
(Martyr, 1997)
This may have contributed to massage
survival into the twentieth century, as
electrotherapy could not really compete
historically on these grounds. But as with
electrotherapy, medical practitioners were
once again to lay claim to massage as
originally orthodox, and then ‘fallen’:
“Today we see this important branch of
medical treatment in the hands of a lot of
people of both sexes who probably know
next to nothing of the art of massage ... and
what is more, they have evolved out of their
own imaginations methods of treatment
which are actually harmful.” (White, 1900)
The ‘history’ of massage was one of
its most important advertisements. Alfred
Peters, a masseur who worked in Perth
and Melbourne in the 1890s, claimed in his
written work on massage that “Massage
... is the revival of a system which has
received the sanction of ages, and has
been approved of by alike by sage and
savage.” (Peters, op cit) He also argued
that: The antiquity and universality of any
therapeutic or callisthenic practice may be
accepted as a strong proof that its efficacy
has been acknowledged by the instinctive
good sense or the concurrent experience
of mankind. And both antiquity and
universality can be predicated of Massage
(Martyr, 1997).
According to Henry, massage “has
a history and tradition as old and as
respectable as the most ancient treatises
on the use of the knife or the application of
drugs can boast of” (Henry, op cit, p 337).
This led him to place massage as a potential
equal of surgery and medicine.
Texts on massage began to appear
in medical journals during the 1890’s.
8
massage australia
Doctors using massage treatment appeared
to associate readily with non-medical
ancillaries. Dr T A Wilson, treating patients
at Creswick Hospital, Victoria, in 1899,
appeared quite at ease with handing cases
over to Mr Hilson, a masseur, although
Wilson advised on the type of treatment to
be administered.
By 1900, the InterColonial Quarterly
Journal of Medicine and Surgery (later the
InterColonial Medical Journal of Australia)
was running advertisements for Miss
Josephine McCormick’s Ladies’ Gymnasium
in Flinders St, Melbourne, which offered
“Massage, Electricity, and Medical
Gymnastics, for the Treatment of Ill-Health,
Spinal Affections, and other Deformities.”
McCormick’s institution was in
competition with the Medical Gymnasium
and School of Physical Culture being run
by the Misses Dick and Gaunt, the modern
version of the 1879 establishment opened
by the former. Both establishments claimed
“Vice Regal and Distinguished Patronage”.
The Australasian Medical Gazette ran similar
advertisements in 1895 for Reuter G Roth’s
medical gymnastics and massage practice,
which also taught massage, and for Albert
Schuch’s massage, medical gymnastics and
fencing training, both in Sydney.
The various forms of physical education
offered at these establishments affirmed
massage’s position among the best
practices designed to improve physical
fitness and create healthy citizens.
By the turn of the century, massage
practitioners across Australia had absorbed
most of the electrotherapy trade....
Massage possessed several
other advantages in comparison to
electrotherapy, which may have assisted
its survival. It could be learnt without any
acquisition of specific scientific or technical
knowledge, although it did require greater
physical effort. While two years’ training
was encouraged by some doctors outside
massage
massageaustralia
australia
9
cover story
Australia, there were few within the country
who could spare the time or effort to train
massage practitioners ‘properly’. In the
absence of formal hospital training, medical
practitioners wishing to use this form of
treatment were faced with three choices.
First, they could provide the treatment
themselves. But as massage treatments
could take up to an hour in themselves, and
be applied several days a week for a period
of several weeks, this was time-consuming.
Second, they could train a massage
practitioner themselves, which could take
up to two years. This was also a dubious
investment, as practitioners tended to
gravitate towards setting up their own
businesses. A doctor could train massage
practitioners and then have them leave
for another city where trade was more
profitable.
The third option was to choose an
already-established practitioner who could
more or less be relied upon to provide the
treatments ordered, and who would work
under medical supervision. This option was
by far the cheapest and most convenient,
and was, therefore, the one most commonly
used. Dr Wilson and the masseur Mr Hilson
are good examples of this convenient
partnership between massage and
orthodox practice in the 1890s. By the
turn of the century, massage practitioners
across Australia had absorbed most of the
electrotherapy trade, and were thus able to
offer a range of treatments to the orthodox
practitioner. (Martyr, 1997)
Another factor which may have assisted in
the survival of massage as a form of treatment
was that there was a market of practitioners
upon which to draw.
NSW
VIC
1891
QLD
5
11
1893
7
20
1895
5
14
1897
6
23
1
1899
14
22
1
1901
13
22
1
1903
24
30
3
35
37
8
1905
2
WA
SA
1
(Martyr, 1997)
In Victoria, massage appears to have
suddenly arrived in 1891, when eleven
individuals advertised. Numbers rose
steadily from 1895, after a brief hiatus, which
may have been connected with a scandal
in Britain. In December 1893, a physician
signing himself ‘FRCP Lond’ wrote to the
British Medical Journal, commenting on
what appeared to be the “excessive supply
of masseuses” in London’s West End.
“According to my own experience,”
he wrote, “there are more masseuses than
there are patients who are willing to pay
for their services, and the gains are to the
instructor.” (BMJ, 1893, p 1259)
In July 1894, the popularity, which
maintained this ‘excessive supply’, became
more easily understood:
“We understand that a good many
‘massage shops’, the advertisements
of which are frequently inserted in one
or two of the fashionable daily papers,
are very little more than houses of
accommodation.... A very common plan, we
are informed, is for some man with a little
capital to open an establishment of this
kind, and then to advertise for half-a-dozen
young lady assistants to do the work.... If
the young lady is willing to make herself
practitioners upon which to draw. Table
3.1 gives some indication of the numbers
of massage practitioners active in major
population centres in Australia prior to
the formation of the Australasian Massage
Association (AMA) in 1906.
“That under the cloak of a useful
form of medical treatment, the grossest
immorality should be practised.... is a
matter of public importance, well worthy
Another factor which may have assisted
in the survival of massage as a form of
treatment was that there was a market of
massage australia
australia
massage
Massage Practitioners, Major Cities 1891-1905.
‘agreeable’ she is retained on the staff,
but if she has conscientious scruples she is
discharged and someone is found to take
her place.” (BMJ, 1894, p 88)
According to the article, more than the
lax morals of fashionable society were at
stake:
“Many of these girls have certificates,
but they, as a rule, have spent their last
penny in getting instruction.... Certificates
in ‘massage’ are given, even by qualified
medical men, after the most perfunctory
course of instruction.” (BMJ, 1894, p 88)
Massage as alternative practice
10
Table 3.1
of the attention of our police and our
magistrates.” (BMJ, 1894, p 145)
This birth of the modern ‘massage
parlour’ had no equivalent in Australia,
although the 1894 scandal did serve to
encourage the eventual registration of
massage practitioners in Britain. What is
significant is that problems in Britain were
used as part of the argument to register
practitioners in Australia in the inter-war
period, over thirty years later (Martyr, 1997).
Formal organisation of massage in
Australia
Given the scandal and the apparently
small numbers in massage practice during
the 1890s in Australia, how did it succeed
in acquiring professional status? The
answer appears to be the ‘associative’ and
‘imitative’ strategies. Like electrotherapy,
massage after about 1890 became
‘certificated’ and ‘scientific’ in Sydney and
Melbourne. In addition to this accreditation,
various organisational practices appear to
have strengthened massage’s association
with conventional medicine. Among these
were the location of massage practitioners
and gender division.
Because of the variations within
Australia’s colonial centres concerning
medical legislation and extent of massage
practice, this discussion will use each in
turn to delineate an overall pattern of
activity. The formal organisation of massage
practitioners must be treated on a stateby-state basis. While Victoria, New South
Wales and South Australia had massage
Tasmania appears to have had a branch
of the Australasian Massage Association from
before the Great War, but little evidence
survives describing its activity.
associations by 1906, Queensland did not
until 1917, and Western Australia did not
have a branch at all. Tasmania appears
to have had a branch of the Australasian
Massage Association from before the Great
War, but little evidence survives describing
its activity.
Sexual division of labour was significant
in early massage practice and organisation.
Willis emphasises the importance of
gender issues in the establishment of
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11
cover story
subordinate-dominant roles in the health
care system. The most obvious example
of this is in the history of nursing, where
the sexual division of labour in a hospital
setting recreated a ‘family’ structure: doctor
as father, matron as mother and nurse as
daughter. There is a popular belief among
physiotherapists in Australia that their
profession has always been exclusively
female-dominated. This is not quite
correct: organisational structures were
actually male and medically-dominated
but most of the rank-and-file membership
was female. This predominance may have
played an important role in determining
the professional structures adopted by
massage, especially in its relation to the
medical profession. Marital status is another
issue: the professional rhetoric of the early
Australasian Massage Association in each
state would appear to indicate that single
women working in massage felt they had
a right and a duty to protect their work
through an active professional association.
It is quite clear that, by the turn of
the century, massage practice in major
eastern population centres was ready and
willing to be subject to the control of the
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medical profession. The advantages of
association in professionalisation at this
time outweighed any benefits of working
independently of the medical profession.
Indeed, in the eastern states of Australia it
was becoming increasingly impossible to do
so. Medical organisation was growing and,
as it consolidated its control of the provision
of health care, groups such as massage
practitioners had an incentive to work
with rather than apart from the medical
profession. Forming the Australasian
Massage Association was part of that
strategy.
REFERENCES
Australian Medical Journal (hereafter AMJ), (1879), p 180;
1882, p 167.
British Medical Journal (hereafter BMJ), 14 July 1894, p 88
BMJ, 2 Dec 1893, p 1259.
BMJ, 21 July 1894, p 145
Henry, L., (1884) “Massage”, AMJ, vol VI n.s., pp 337- 8.
Henry, op cit, pp 339-341.
W Murrell, “Massage as a therapeutic agent”, BMJ,
1886(1), p 926.
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