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, de 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 treatment 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.

* Rothstein wrote, amongst other things, "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 Leibesubungen," Berlin, 1852. Eulenberg, amongst other things, "Die sehwedische Heilgymnastik," Berlin, 1883.

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 de therapeutique 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) who rendered the greatest services in this as in so many other directions. A strong impulse was undeniably given by the well-known Dr. zMezger, 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 Langenbeek 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 much misused and advertised by charlatans could equally little lower or raise their real worth. In the north, especially in Sweden, which since Ling's time was the home of massage and medical gymnastics, Ling's pupils, especially de Ron, Thure Brandt and Berglind, helped to strengthen the reputation of these methods of treatment, and Mezger's massage was also represented in Sweden, amongst others by his pupils Berghman and especially by Helleday, in Norway by Kiaer, and in Denmark by E. Johnsen.