MASSAGE AND BODYWORK
The Art of Rubbing
The art of massage holds an important place as a therapeutic modality in Greek Medicine. The classical Greek term for it is anatripsis, which simply means "friction" or "rubbing". This art of rubbing can include auxiliary medicinal agents, like liniments and medicated massage oils, or it can be just simple dry massage.
Hippocrates and Massage
Hippocrates had a high regard for massage, and considered it to be one of the arts with which a well-rounded physician should be familiar. However, he cautioned that a real proficiency in this art doesn't come quickly, but rather, with lots of hands-on experience.
According to the way in which it was applied, massage could either firm up muscles or organs that were too lax, or relax muscles, joints or other organs that were too stiff, rigid or tense. Since this was also seen as one of the basic aims of exercise, massage and exercise went hand in hand as therapeutic modalities for optimizing body suppleness and tone.
Hippocrates also freed magic from the realm of magic and superstition and established it on a rational scientific and physiological basis. Primitive shamans, in their efforts to banish the negative spirits and energies that were causing illness, tended to stroke the limbs of the supplicant from the center out towards the extremity. Hippocrates reversed this basic direction by maintaining that, in massage, the strokes should be predominantly towards the heart, thus assisting the heart and circulatory system in its work, and in transporting and finally eliminating pathogenic wastes and toxins from the organism.
In matters of massage, Hippocrates outlined four principal guidelines:
Vigorous massage constricts and firms up the body.
Gentle massage relaxes the body.
Much massage thins and lightens the body.
Moderate massage thickens the body, and increases the flesh.
The body and its muscles react similarly in kind to vigorous massage by firming up and increasing their tone. Laxness and atony are low energy states; vigorous massage stimulates, putting a lot of heat and energy back into the organism. Vigorous friction and massage are also great ways to warm up a body that is too cold.
The body and its muscles also react similarly in kind to gentle massage by loosening up and letting go of pent up stress and tension. This dispersal of energy leads to a cooling or sedating effect.
The qualitative vector of vigorous / gentle is the primary one to consider when it comes to massage, and corresponds to the primary polarity of the Four Basic Qualities: Hot / Cold. Vigorous massage puts a lot of activity and energy into the body, and is heating. Gentle massage allows pent-up energy to disperse, and is cooling.
Much massage thins the body by continuously kneading, stroking and pressing out accumulations of superfluous or morbid humors. This continuous dispersion not only increaes circulation and relieves congestion, but it also stimulates the eliminative functions of the organism.
Moderate massage thickens the body and increases flesh by enhancing the permeability
of the muscles and tissues to the subsequent influx of nutritive substances from the blood, plasma and lymph. Thus, moderate massage's ultimate effect is to enhance the nutritive status of the organism.
The quantitative vector of much / moderate corresponds to the secondary polarity of the Four Basic Qualities: Dry / Wet. By removing superfluous or morbid humors from the tissues, and ultimately from the body, much massage is drying. By enhancing the permeability of the tissues to inflowing humors and nutritive fluids, moderate massage is moistening in temperament.
With the correspondences between the basic types of massage and the Four Basic Qualities thus established, we have our basic parameters of massage treatment set out. This enables us to adjust the quality and quantity of our massage to the temperament of the individual receiving it, the situation, condition and circumstances, and the effects desired.
Massage in Ancient Rome
In the early days of Rome, the medical profession wasn't held in very high regard. There was no formal medical licensing until about 200 A.D.; the practice of medicine was open to all with the inclination, and was based on experience. Wealthy Roman families kept slaves called Aleiptes, who were their medics and masseurs. Some were highly trained and educated physicians from Greece, who didn't really become freedmen free to practice their trade publicly until the early days of the Empire.
One remarkable such medic / masseur was the Greek physician Asclepiades (124 - 40 B.C.E.). Asclepiades was the consummate master of massage; his top thre preferred therapeutic modalities were all drugless forms of physiotherapy: hydrotherapy, exercise, and massage - in that order.
So great was Asclepiades' mastery of massage that his most famous cure was to bring a seemingly dead man, in his coffin and on his way to burial, back to life with nothing more than what was described as "several minutes of manipulation". Although Asclepiades didn't subscribe to Hippocrates' humoral theories, he had his own corpuscular theory: that Life was due to the constant motion of atoms in the body; that disease and death result when this movement is obstructed or disrupted.
Dr. Harvey Kellogg, founder of the famous sanitarium in Battle Creek, Michigan, drew a lot of inspiration from the life and teachings of Asclepiades. Dr. Kellogg noted that Asclepiades eventually renounced all medicines in favor of manipulation and massage.
Celsus' Guidelines for Massage
Aurelius Cornelius Celsus (25 B.C.E. - 57 C.E.) was a Roman physician and medical historian who is said to have written the first history of medicine. He also wrote an eight volume treatise on medicine entitled De Medicina.
Celsus was basically a follower of the humoiral theories of Hippocrates, and was a great believer in the efficacy of massage. He elaborated and expanded on Hippocrates' famous four guidelines for massage treatment and extrapolated from them further guidelines for the application of massage, which are as follows:
Do NOT apply massage in the crisis stage of acute diseases, or when the acute disease is advancing towards the crisis. Massage may be applied after the acute crisis has started to subside, or when acute diseases are in remission - and then only on an empty stomach.
Do NOT apply massage when there is a fever. Massage may be applied during the rigors, or intermission phases of an intermittent or periodic fever, when no fever is manifestly present.
When giving a whole body massage, you should gauge the amount of massage you give according to the patient's constitution. Patients with a strong, robust constitution will be able to withstand more, and more vigorous massage than those whose constitution is weak and debilitated, who must be handled gently.
When giving a whole body massage to a weak and debilitated patient, you must take care not to rub too vigorously, or with too much pressure, for too long a period of time. When massaging only a limb, extremity or part of the body, these precautions aren't necessary, and one can massage as the condition demands.
When massaging a palsied limb, the friction should be applied to the parts distal to the most afflicted and painful poart, which should not be massaged directly. Massaging the distal parts will draw blood out through the whole limb, including the painful, afflicted area.
Do NOT massage a pregnant woman on the abdomen.
Exercise and Massage
When giving a massage, the massage therapist has to noit only consider who the massage is for, but also when it's given, and for what purpose. A case in point is how massage was used by the ancient Greeks and Romans as part of a regimen of exercise and physical culture.
The pre-workout rubdown was designed to prepare the body for vigorous physical activity without strain or injury. You could say that it fulfilled the same purpose as warm-up calisthenics do today.
The paraskeuastic or preparatory massage started with a quick friction rub with a mitt made of coarse linen or muslin cloth, given with moderate pressure, so as to bring warmth and heat to the muscles, but not to arouse undue tension. This initial friction rub prepared the body to receive the oil.
Then, the body was only very lightly anointed with oil, to loosen the muscles enough to make them supple, but not so much as to make them lax. In keeping with this objective, the body was then given a short massage of moderate pressure and vigor - vigorous enough to stimulate, but not tighten; and gentle enough to achieve the necessary suppleness yet maintain tone. The purpose of this preparatory massage was to open the ducts and pores and thin out humors that had become too viscid and thick.
The post-workout bathing-and-massage routine was called apotherapy. It was designed to promote relaxation and relieve tension and fatigue. Here, prolonged massage, with a liberal anointing of oil, was indicated and appropriate. As for the bathing part of the routine, it is described in the article, The Greco-Roman Bath in the Hygiene section.
Galen's Guide to a Great Massage Oil
One of the things Galen discusses in his treatise on Hygiene is how to make a great massage oil. To make a massage oil, a base oil or oils are mixed or impregnated with various resins, essential oils and aromatic medicinal principles.
Today, making a good but basic massage oil is a relatively simple affair. A base oil is mixed with essential oils in certain proportions, and that's it. But how was it done back in Galen's time?
For therapeutic massage purposes, Galen's preferred base oil was Olive Oil, which he considered to be completely balanced in temperament, or the Four Basic Qualities. Moreover, the best kind of olive oil was what he called Sweet Oil, or Sabine Oil - olive oil from the Sabine region of Italy. He considered this oil to be superior for oleation and massage because it had no trace of harshness, bitterness or astringency. If real Sabine Oil should be unavailable, a high quality Pomace Oil will do.
Because olive oil is so balanced in all its qualities, it's most suited as a base oil for those of a fairly balanced temperament. However, there are many other fine base oils out there that, due to their special virtues, are more suited to those of different temperaments, and for different conditions:
Castor: A very thick, unctuous, heavy oil, slightly heating. Great at dispersing obstructions, congestion, plethora, and at drawing out pus and purulent toxins. Excessive use can aggravate heat and choler. Very penetrating.
Coconut: A rich, thick, heavy, cooling oil that nourishes the Phlegmatic humor and cherishes the inherent moisture of the organism. An excellent moisturizer indicated for all dry conditions. Contraindicated for Phlegmatics.
Grapeseed: A very light, subtle, penetrating oil. Great for Phlegmatic and Sanguine types, and conditions of phlegm and dampness. Not favorable for Melancholics, who need a heavier, more grounding oil.
Sesame: The base oil of preference for Melancholics. Rich, heavy, soothing, warming and unctuous.
Sunflower: The most cooling oil. Best for Cholerics. Contraindicated for Phlegmatics, or those suffering from conditions of coldness and phlegm.
Massaging with pure base oils is only recommended for those with no marked toxicity or humoral aggravations that are compromising their health. To check for toxicity and humoral aggravations, look at the tongue: if there is a marked, thick or turbid tongue coating, pure base oils are contraindicated and medicated oils, as appropriate, must be used.
There are several ways of medicating oils. In Galen's time, the fresh cones of the Fir tree (Abies picea) were mashed up and soaked for 40 days in olive oil in a dark, warm place in a stoppered jar. Alternatively, the fresh buds of the Poplar tree (Populus nigra) were mashed and extracted in oil for their medicinal oleoresins.
To enhance the extraction process, the oil and the aromatic cones or buds were put into a pot and heated slowly, over a very low flame. To avoid burning or smoking the oil, a double boiling process was also used, in which the pot with the buds and oil was put inside a larger pot of boiling water. Nowadays, an electric crockpot is excellent for this purpose.
Instead of Fir cones, those of other evergreens, like Pine, Spruce or Larch, may also be used. And a good substitute for Poplar buds in the United States is Balm of Gilead buds (Populus candicans), which is actually another species of Poplar.
The aromatic essence of the Fir cones, when dissolved in the oil, Galen said to be good for those whose flesh was congested by excess Phlegmatic fluids, lymph and dampness. These essences also have a diaphoretic effect that opens the pores and promotes sweating. The essence of the Poplar bud is also stimulating, and no less of a diaphoretic than the Fir.
When soaking the Fir or Poplar in oil, cover it with enough oil to leave an inch or two of oil above the crushed cones or buds. Strain or press out the oil after soaking for 40 days, or after simmering it slowly for several hours.
Galen then instructs us to melt some Fir resin into the oil, and then to thicken the oil with Beeswax in a ratio of five parts oil to one part wax. Another valuable therapeutic ingredient that was often added was Terebinth, or natural turpentine (Don't use the turpentine from your local hardware store!) Terebinth, in a massage oil, is one of the best muscle relaxants and antirheumatics known.
The essential oil of Fir is balsamic and pectoral in that it opens up the lungs, chest and respiratory passageways. It's also antirheumatic in that it relieves rheumatism and muscular aches and pains. It's also antiseptic and antimicrobial in fighting infections and putrefactions. It's also anticatarrhal in respiratory colds and congestion, and a stimulant to the circulation and metabolism in general.
When using Fir essence, Terebinth, or other essential oils in a massage oil, put them in in the ratio of one tablespoon of the essential oil or essential oil blend to a cup of the base oil. Other essential oils that work well in a massage oil and mix very well with Fir essence are the essential oils of Cinnamon, Laurel, Juniper and Lavender.
Conclusion and Internet Resources
A very excellent series of articles on the history of massage is available on the website: www.massagemag.com which I referred to in the preparation of this article. Especially valuable were the following pages / articles:
The author of these excellent articles admits that, although the Hippocratic writings contain only scattered, terse sayings and aphorisms about massage, their apparent simplicity hides deep healing wisdom that only becomes apparent after years of experience in massage therapy.