Greed, Jealousy and the Demise of Medical Physiotherapy

Before its adoption by laymen (or more correctly, laywomen) the word ‘physiotherapy’ was used by the medical profession to describe all of the physical agents, including the X-ray. In the 1920s, radiology became a unique medical specialty, but for a brief period in the nineteen tens and twenties it was a combined medical subgroup.  A historical review of some of the agents of medical physiotherapy at that time by the Publication Committee of the Canadian Radiological Society explores the background to the development of light therapy, hydrotherapy and electrotherapy.

Whilst providing an interesting global historical tour of three agents of physiotherapy it is the article’s conclusion that is of greatest interest.  It is a mournful lament of the lack of use of physical agents by the medical profession.  An explanation is provided of how the base human traits of greed and jealousy, contributed to medical practitioners failing to embrace the methods of physiotherapy.  With the benefit of hindsight, it is likely that the medical profession’s withdrawal may have benefited the laywomen who moved into the subsequent vacuum to become the physiotherapists of today.

Titled, “The Historical Background of Physio-Therapy”, the article is reproduced in full below, with headings provided to improve readability.

Introduction

That there is a definite cycle in the affairs of men is a fact that needs no further comment, for it is a matter of very commonplace observation with the members of the medical profession. To what extent cycles have influenced the whole field of medical endeavour it is quite impossible even to hazard a guess, but in the more limited field of therapy by physical agencies there can be no question of its influence. As limited as is the field of physio-therapy, to do even scant justice to its historical background in a brief way it seems desirable to divide the field into subdivisions, and so for our purpose we shall consider the history from the viewpoint of light-therapy, hydro-therapy, and electrotherapy.

Light Therapy

Light-therapy came first into being when man made his primitive debut, for science has amply revealed that light, a constant factor of environment, not only protects us from disease but relieves many of our disease necessities.

When Aknaton, the first Pharaoh, 3,000 years ago, set up “Alton Ra,” the Spirit of the Sun, as a God to be worshipped by the people, he recognized apparently in a very full measure the blessing mankind normally receives from the sunlight. This recognition apparently became shortly widespread, for throughout the early history of the Egyptians, Greeks and Romans, literature very frequently refers to the treatment of diseases by light, and in the writings of Hippocrates, Celsus and Galen, the application of these teachings is revealed. In Pliny’s writings is recorded “Sol est medendorum maximum,” an admission of the time that must carry conviction if we are inclined to question the fact of the very early advent of light-therapy.

To Newton, more than to any other, must go the credit for first preparing the way for placing the subject of light on a scientific footing, but to Finsen must ever be conceded first place in putting light on a sound, scientific basis from a medical viewpoint. Finsen’s work in treating and curing lupus prepared the medical mind for intensive research, an effort that has not lessened to this day. Bernard’s work in healing chronic infected wounds with light, and Rollier’s and Sir Henry Gauvain’s intensive work and extensive writings in more recent times in relation to tuberculosis and light-therapy, cannot but convince the most sceptical that the advent of light-therapy is one of the greatest advances that has ever been made in therapy.

Hydrotherapy

Enthusiastic historians tell us that the oldest form of therapy is hydro-therapy, but it is possibly an open question as to whether it actually antedates light-therapy in antiquity. There is ample historical evidence, however, to convince one that from earliest times the Egyptians, Greeks, Romans, Persians and Assyrians have had a rather complete working knowledge of hydro-therapy and if we appeal to the writings of Hippocrates we shall readily see that his conceptions of hydro-therapy were advanced indeed. In early Sparta cold bathing was by law compulsory, and Pliny tells us that for five centuries Roman emperors vied with each other in building more and more elaborate baths where people might attend for treatment and health preservation purposes. Many a traveller to the Far East can testify with his life to the efficacy of hydro-therapy when smitten with fever when travelling through those areas.

To Priessnitz, of Silesia, a common peasant, must go the honour of popularizing hydrotherapy in Europe; not only was his work recognized by the profession but he was granted a diploma by the Austrian government, and representatives from many European governments went to observe his work and report on his achievements. To Winternitz, of Vienna, however, belongs the honour of thoroughly studying hydro-therapy and establishing for all time this art on a scientific basis. Only those who have studied these principles and have followed the work as laid down by Winternitz are in a position to appreciate what hydro-therapy has accomplished. By scientific hydro-therapy alone the typhoid death rate was reduced in New York from 20 per cent to 6 per cent with the introduction of the Brandt bath.

Electrotherapy

At first thought it might appear that electrotherapy is a product of recent years, but static electricity was described by Thales of Miletus in 600 B.C., and in 79 A.D., Pliny prophetically writes that the paralyzing shock of the torpedo fish (that inhabits the Mediterranean) might be used in treating disease. In the reign of Queen Elizabeth Dr. Gilbert wrote extensively regarding magnetism, and a half century later the first primitive static machine was made in Germany. One century later Winkler, of Leipsic, introduced the first powerful static machine and, slightly later, the principle of the Leyden jar was discovered. Shortly after this time static machines appeared in England, and in “Primitive Physic,” written by John Wesley in 1780, he describes many conditions successfully treated. From his writings it would appear that the profession was rather sceptical, for he makes a strong plea for them “not to condemn that which they know naught of, but to make a trial and then their own senses will tell them whether it is’a plaything or the noblest medicine known in the world.”

That happenings small in themselves may readily offset the advantage of much greater things is very well known. In 1753, Kratzenstein, the father of electro-therapy, was invited by the King of Denmark to investigate the relation of electricity to the treatment of disease. So impressed were those that came in contact with his work that shortly the word passed around that he was working magic, and in a very short time it was impossible for him to secure lodgings in Copenhagen. Again we see this, in the case of the Abbé Nollet, who was summoned by the King of France to demonstrate the wonders of electricity. In his enthusiasm to make a mighty showing he had a great company of good common folk join hands and they formed a circle that was 1,800 yards in circumference. When the current was turned on, with one and common accord they straightway leapt into the air, and with them went all chance of ever giving them thereafter therapy dosage of static electricity, “for truly this must be magic.”

About this time Galvani made his early discoveries in the field of galvanism and thought he had discovered “the essence of life.” Volta, however, pointed out the significance of his findings. The works of these two men had the effect of preparing the way for Vorsted’s works at Copenhagen, who in 1820 laid the foundation work that Faraday seized upon and in 1830 made, as a result, the first Faradic coil. Shortly after this (1836), Dr. Golding Bird opened in Guy’s Hospital, London, an electrical department.

Bird’s work was conscientiously done and was extremely meritorious. For electrical workers it is interesting to note that in 1847 he addressed the Royal College of Physicians on physiology and therapeutics and presented electro-therapy as a “highly rational but fallible remedy.” With considerable heat he noted that the patients referred to the department usually came with the instruction “let the patient be electrified” and no account was taken of the disease condition or mode of application, “and further the cases referred were absolutely hopeless from any other viewpoint.” His work on copper ionization of chronic ulcers was well received and during his address he made reference to the fact that Thomas Spencer Wells (afterwards Sir Thomas) had used the principle in treating casualties of the Crimean War.

Duchenne, of Boulogne, another tireless worker, in 1830 addressed the French Academy of Science on physiology, pathology and treatment; on his monumental work the edifice of neuropathology has been built. In 1898 D’Arsonval revealed to the world the principle of the high frequency machine and in 1907 Nagelschmidt, of Berlin, unfolded to the medical world the secret of its power in favourably influencing disease.

Conclusion

Thus in quick review are shown glimpses of the evolution of the art of treating disease by physical agencies. Cyclic indeed has been its turns. On many occasions has this art reached a pinnacle, to be dashed again apparently to abysmal depths. The mysticism that has so long rounded the field of electro-therapy and has touched so often the minds of men has been the very thing that has been seized upon by unscrupulous charlatans to the later temporary undoing of much that had previously been so long and painstakingly built upon. The most notorious forms of quackery have seized upon practically every noteworthy advance that has been made in the field and bad odour has been the net result.

Since the greatest primary advances have been made practically without exception by laymen, in contra-distinction to medical men, it is not hard to see how at times it was difficult for the profession to accept the new theories and teachings that were advanced since to them “they were veriest heresy, being empiric.” It is equally easy to see how physio-therapy would have been saved much indignity had the profession the courage to “examine and see,” as John Wesley had exhorted, or if they had been convinced at an earlier date by the leadership that was given by men of such type as Bird.

In daily service, since the dawn of light on the earth, physical agents have ever been active in promoting health, happiness and well-being, matters of supreme importance to the medical profession, yet it is only today that our teaching schools, generally, are beginning to establish Chairs of Bio-physics, in order that their graduates may be efficiently taught the relationship of physiology, pathology and physio-therapy.

Born of the dark ages, empiricism has been the cloak that has inconsistently separated the profession from the recognition of this, one of the most rational of all therapeutic measures. No treatment devised by men has ever been other than empiric in its inception, and very much indeed of that which to-day is recognized as “good” in the profession is still “empiric,” though extremely useful in relieving sickness and distress. Truly, as Hippocrates wrote years ago: “Life is short, art is long, and judgment difficult.”

References:

Publication Committee of the Canadian Radiological Society. (1931). The historical background of physio-therapy. Canadian Medical Association Journal, 24(2), 263-265.  Accessed online at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC382309/ on 19 January 2024.