From time immemorial people of all races have had some idea of the hygienic and therapeutic importance of physical exercise. Gymnastics in some form has therefore always been used, sometimes as exercise in the open air, sometimes, and especially in the ancient civilisations, as a more or less developed system of positions and movements.

It has also been understood from time immemorial that many local and general diseased conditions may be cured or relieved by mechanical treatment of the soft parts in the form of movable pressure, by stroking, rubbing, kneading, as well as by clapping and beating. Massage, as well as gymnastics, is a very ancient form of treatment, so ancient that one may consider its history to be as old as that of mankind, and its beginning prehistoric.

Gymnastics and massage, treatment by exercise of the motor apparatus, and treatment by manipulation of the soft parts have so much in common that their history may well be given together. Both methods of treatment are practised by the same craftsmen, and have so much in common that unintelligent people who have used them both for years are often unable to draw a distinction between them which can be understood by people of ordinary intelligence. For the most part, nowadays, in all civilised countries a distinction has been made with more or less clearness between massage and gymnastics.

It has been the fashion among historical writers on the subject to assert that the earliest writings on massage and gymnastics are found in Kong-fu's Chinese "White Books," of great but uncertain antiquity, as well as in the earlier of the Indian Vedas, called the "Ayur-Veda," written by Susruta, the pupil of Dhavantare, who is said to have lived in the eighth century. According to Nebel, no clear expositions of medical gymnastics nor evidence of Chinese massage of remote antiquity are found in Kong-fu's work, and Daily's complaint against the Swedish gymnasts of having plagiarised from their Chinese colleagues is absurd. Neither has Professor Pagel of Berlin found anything on these subjects in the "Ayur-Veda," but this does not throw doubt on the fact that mechano-therapy, especially in the form of massage, is many years old in India, and probably also in China.*

* See, concerning ancient Asiatic mechano-therapy, Pere Amyot's "Memoire con-cernant les Chinois" (1776), Lepage's "Recherches Historiques sur la Medecine des Chinois" (1813), Hue's " L'Empire Chinois" (1831), Dr. Wise's "Commentary on the Hindoo System of Medicine," Calcutta, 1845, and H. Nebel's articles in Langenbeck's "Arkiv.," Bd. 44, and in "Deutsche Med. Wochenschrift, 1887."

The ancient Egyptians probably knew massage and medical gymnas-tics in some form.*

From the ancient Greeks we have interesting information on the subject. Gymnasia with their attendants (the chief "physical treatment" quacks of ancient Greece - its "gymnastic directors") were the places for such treatment. Herodikos, or as he is also called Prodikos of Selymbria, who appeared shortly before Hippocrates, was such a gymnastic director of the cocksure uncritical type, and treated even febrile diseases with a form of "terrain-cure."

Hippocrates (460 - 377 B.C.) mentions the utility of friction after sprains and reduced dislocations, recommends abdominal kneading for constipation, knew of chest-clapping, "terrain-cures," etc.

Among the many benefits of culture which Greece imparted to the conquered Romans were some in the department of medicine, and mechano-therapy flourished in Rome, chiefly owing to Greek influence. Some of Rome's most famous doctors were Greeks, and among their names is that of Aselepiades, who practised shortly before the Christian era, and who employed massage and gymnastics freely, and according to Pagel seems to have been the father of mechanotherapy in the Roman world. We learn also from Roman literature in the dawn of our own time that both gymnastics and massage were highly valued by the profession and the public. The fact that Galen (a.d. 131 - 201), the most eminent doctor of the Roman Empire, gave it great attention had an important influence on mechano-therapy. His influence, as we know, extended several centuries beyond his own time, and it is partly due to him that this method of treatment did not entirely fall out of use in the Middle Ages. Thessalus of Tralles, Aretaeus of Cappadocia, Rufus of Ephesus, bear witness that both gymnastics and massage had a certain time of prosperity under the Roman Empire. It is very interesting to find that the last-named shows the scientific spirit by mentioning kidney disease as a contra-indication to gymnastics. Obesity, gout, paralysis and many other diseases were treated by mechano-therapy. About a.d. 250 Flavius Philostrates produced his great work on this method of treatment. Alexander of Tralles and Paul of AEgina also belong to this period. The latter specially mentions mountain climbing. In the fifth century Oribasius wrote his well-known work, which is our chief source of knowledge of ancient mechano-therapy; in the sixth century we find from a work on the treatment of obesity that gymnastics was still alive; in the seventh century Aetius of Amida wrote of active and passive movements, resistance movements (see later concerning Ling), and friction.

The further we follow the literature of the Middle Ages, the fewer signs of life do we find in mechano-therapy, and it seems to share the fate of all knowledge in not being able to advance without at the same time losing much of what has already been won. It is obvious that the seeds sown by previous generations would find the conditions of life unfavourable in an age which more and more turned away from experience towards pure speculation, and finally took refuge in complete mysticism. It is true that the Arabs, whose dominion over medicine (from the ninth century) extended over several centuries, followed for the most part the teaching of Galen, and could not therefore quite neglect a treatment so highly valued by him. Avicenna, in particular (born a.d. 980), was interested in physical treatment, especially gymnastics. The monks, too, who were the chief practitioners of medicine in this period, were, as doctors, followers of Galen. But the Arabs turned in preference to pharmacology for their therapeutics, and the monks found prayers and exorcising easier than massage and gymnastics.