EJANZH: Martyr on Quackery

Dr P J Martyr, Department of Nursing, University of Tasmania

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 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.

There are two major sections:

• A: The Case of Electrotherapy, 1870-1900
• B: The Case of Massage, 1880-1906

A: The Case of Electrotherapy, 1870-1900

1. Orthodox medicine and electric treatment

Electrotherapy is a form of treatment whose basic aim, when used as a physical therapy, is to heal by stimulating activity in wasted or damaged muscles, and to promote healing by the increase of circulated blood in those areas.[1] It can and has been used for the relief of pain, and for minor operations such as the removal of ulcers and cysts. Dr W Carey Rees described the basics of electrotherapy in the Australian Medical Journal in 1874, distinguishing between static and dynamic electricity, and describing two forms of the latter in galvanism and faradism. Galvanic current was “of low intensity, but of considerable quantity, and produces very considerable results on temperature, and very appreciable chemical results.”[2] Faradic current, or “induced electricity”

has almost no chemical action, almost no effect on temperature, causes no burning feeling, no sensation of heat, like that produced by the simple current from the battery; but it produces marked contraction of the muscles, and a powerful action on the nerves of both motion and sensation.[3]

Electrotherapy has a longer history of use for psychiatric disorders, but as a form of physical therapy, it appears to have been used slightly earlier in Australia than massage treatment. The Australian Medical Journal reprinted a case from the Medical Times of March 1858 on faradisation, possibly indicating an interested Australian medical audience for this treatment.[4] In 1874, Rees had used electricity to treat all forms of paralysis experimentally, including hemiplegia, spinal injury, rheumatism and infantile paralysis. He noted the reception of electrotherapy into Australian medical circles:

I feel convinced that in this colony we have not made sufficient use of this method of treatment …. [U]ntil very lately, the therapeutic use of electricity, in most general hospitals, has been left in the hands of paid electricians (often not medical men), and even medical men themselves held galvanism in very low estimation, reports of cures by electricity being received with an incredulous smile. [5]

Rees extended his inquiries into the field in 1877, stressing that “Medical, not lay, men have been appointed as electricians to the leading hospitals of Great Britain.”[6]

The approaches being used to treat disabilities were under the control of the practitioner. It is clear from Rees’ work that medical practitioners were purchasing and using electro-therapeutic devices themselves.[7] Treatments depended upon the diagnosis of the condition, which basically consisted of the practitioner deciding whether to apply galvanic or faradic currents.[8] Divergence from this rule was viewed as reprehensible:

The application of electric, more especially galvanic, baths by non-medical hands is objectionable; for it requires on the part of the operator exact diagnosis and judgement of the complaint, as well as great familiarity with the effects of electricity, which can only be obtained by a thorough and special medical training.[9]

And yet there was no means of ensuring that training for either medical or non-medical practitioners, apart from the consultation of the few available texts at the time. What was to take place in the early 1890s was the annexation of an unorthodox practice, which existed in Australia at the same time as the surge of medical interest which legitimised its existence.

Sydney acquired a galvanist in 1891.[10] Melbourne in 1885 had William Kyte’s Electric and Thermopathic Institute, which stayed in business till 1888, and was not succeeded until 1893 with Albert Lewis’ Electropathic Institution.[11] In 1889 a medical galvanist was operating from Albert St, Brisbane.[12] The use of electrotherapy in the eastern colonies appears to have reached a peak in the early 1890s: unorthodox practitioners of electrical treatments appear to have been at their most numerous at this time. Howard Freeman, one of Australia’s most prominent unorthodox practitioners,[13] had formed a partnership with J Hoerchner in Brisbane in 1892-3, practising in medical electricity. Hoerchner’s reputation somehow survived this experience, as he continued practising in this trade until the late 1890s.[14] A number of massage practitioners in major cities began to add electrical treatment to their advertising spiels.

Electrotherapy was available in eastern Australia from the early 1880s. The supply of practitioners was irregular in both senses; that is, intermittent and untrained. Electrotherapy was not available to the general public in Western Australia and South Australia until the early 1900s.[15] Yet orthodox interest in electrotherapy, in the form of experimentation with its effects reported in Australian medical journals, appears to have emerged earlier, in the 1870s. Medical practitioners were buying electrotherapeutic equipment from dealers such as Lightfoot and Beak in Brisbane, and using it themselves.[16] There are few cases of doctors reporting the employment of a non- medically trained individual, such as Mr Millikin, honorary galvanist at the Adelaide Hospital, to handle their cases.

Was it orthodox interest in electrotherapy that led those outside of orthodoxy to electrotherapy’s potential as a source of income? While imitation may be the sincerest form of flattery, for the unorthodox medical practitioner it was often the simplest source of profit. Or was the attractiveness of electrotherapy in the public marketplace the reason it appealed to orthodox practitioners, perhaps in need of extra custom? As is usually the case in chicken-and-egg debates, the safest answer is to assume the two influenced each other. In this case, the safest answer does not fully reflect the unorthodox practitioner’s relations with orthodox medicine. In 1891, Dr C Eardley-Wilmot was proud to announce that:

thanks now to the fact that the subject is largely out of the hands of quacks and charlatans, … we are rapidly elevating the subject of electro-therapeutics from mere empiricism to a rational treatment, founded on a sound scientific basis.[17]

An examination of electrotherapy’s status as an unorthodox practice may reveal a more complex relationship.

2. Electrotherapy as alternative practice

There were no legal strictures on the practice of electrotherapy, so practitioners were free to do as they wished.[18] Electrotherapy was a form of medical treatment open to the public, and could only gain custom through attracting the public’s interest. This was done through advertising, the classical resort of alternative practice, wherever possible: in pamphlets, newspapers, and the Post Office Directories. Some, such as R Bernard Job, went straight to the point and listed the conditions they felt qualified to cure: “Rheumatism, Nervousness, Neuralgia, Paralysis, Strains, Sprains, Sciatica, Stiff Joints”.[19] Others, like Hermann Roth, offered a range of different services: massage, electricity, and Ling’s exercises.[20] Among the most important sources of custom were doctors. Even if it failed to provide direct referrals, their interest in electrotherapy or their willingness to experiment on their patients with electrotherapeutic techniques may have created a subsequent public demand for electrotherapy, as a treatment for real or imaginary complaints. Cautions appearing in medical journals, in the form of admonitions to fellow doctors not to regard either electrotherapy or massage as a cure- all, suggest that many doctors perceived an element of faddishness in the adoption of both methods.[21]

When T G Hodgkinson patented an “Electro-Neurotone Apparatus”, three Sydney doctors came forward to endorse it.[22] Texts on the use of medical electricity began to appear in medical journals, and by 1893, Adelaide Hospital had an honorary galvanist.[23] Orthodox interest in electrotherapy may have encouraged the increasing prominence of the ‘qualified’ electrotherapeutic practitioner in this period. Before medical interest became a factor in the early 1890s, credentials were rarely bandied about, but there is a noticeable shift in this approach from 1893 onwards. In Melbourne, Albert Lewis became “late of the Leipzig University”, and Herr Grundt advertised that he had experience based on “several years practising under Melbourne’s leading doctors” as a “certificated masseur”.[24]

If one lacked credentials, patronage could be useful. Maurice Krone of Melbourne, advertised that, in addition to his electrotherapeutic skills, he had served as “masseur to his Excellency Lord Hopetoun”.[25] Bernard Job in Sydney also laid claim to the patronage of “Their Excellencies Viscount Hampden and the Earl of Hopetoun”. [26] Failing aristocratic patronage, the traditional testimonials would guarantee ability. Mrs Holder carried “numerous testimonials from doctors and cured patients”,[27] and G Moreno held “highest testimonials certifying to extraordinary cures”.[28] Awareness of medical interest in electrotherapy had almost certainly filtered through to some sections of the public who could afford to be more selective about whom they attended. The available market of practitioners accordingly redefined themselves as qualified and legitimate practitioners, using whatever means were available.

3. Electrotherapy and legitimacy

The appropriation of an unorthodox practice by the medical profession was well under way. Theodore Kendall, a Sydney doctor, argued that the haphazard use of electrotherapy by medical practitioners in the early 1800s, allowed a valuable technique “to fall into the hands of quacks and charlatans”.[29] In other words, electrotherapy had been at one stage in the hands of legitimate practitioners, who then lost it to those outside the medical pale. Historically, this is a dubious argument.[30] It serves, however, to illustrate a shift in thinking about unorthodox treatments which helped to justify their use by orthodox practitioners. Practitioners of electrotherapy in turn bent their therapy to fit the medical bed of Procrustes. Certification was demanded by orthodox practice, as an indication of ‘proper’ training. If the electrotherapist was unable to prove that s/he had been actually trained, at least `certification’ could be provided in abundance.

Electrotherapy had, however, perhaps bent too far; legitimate or not, it failed to survive as a separate form of practice. There are a number of possible explanations for this. First, the practice may simply have gone out of fashion as a form of popular medicine. This would appear to be supported by the number of electrotherapists who subsequently branched out into other forms of treatment such as hydrotherapy, becoming general therapists rather than specialising in electrotherapy.[31] This tendency to branch out forms part of the second possible explanation, which is that because of this tendency, electrotherapists never felt pressured to form an organisation to protect their interests. There was usually a second or third form of practice which they could acquire in order to operate successfully. Electrotherapy did not occupy a substantial portion of working time or physical energy, as did massage. A further complication with electrotherapy was that while the basic materials for practice could be costly, so could their incorrect use, as in the case of the death of a female patient at Miss White’s Electro-Medical Institute in Kalgoorlie in 1908. At the inquest, the magistrate expressed a heartfelt desire to see all similar institutions closed by law.[32] The incorrect application of other therapies such as massage could injure patients, but was less likely to kill them outright.[33]

Electrotherapy appears to have faded away as a discrete entity in Australia after the turn of the century. The exception to this is Victoria: from 1897, ‘medical electricians’ gained their own listing in the Trades section of the Post Office Directory. Practice appears to have reached a peak in about 1907, with 16 practitioners, and then slowly dwindled. By and large, these practitioners appear to have been working as massage practitioners at the same time, capitalising on dual listing to augment their advertising. In 1900, three of the nine men advertising were also listed as masseurs, whereas the following year, the entire list of five medical electricians was simultaneously listed under massage. Electrotherapy appears to have become gender-specific at this time. The majority of practitioners in each year, if not the total number, were men.[34]

Electrotherapy had an open market and direct access to the public. Yet there were no signs of occupational organisation, even in these conditions where business was flourishing and competitive. One possible explanation is that the electrotherapy trade was able to survive and support this number of practitioners without occupational organisation, so long as there was a negligible amount of medical criticism. The case of electrotherapy, at least in Victoria, indicates that while occupational groups which succeed in professionalising are usually male-dominated, the reverse is not necessarily also the case.[35]

Professionalisation is a process rather than a status that is achieved at a specific point in time; nor can it be said to come to an end at any given time. Rather, the definition of ‘professional’ is constantly changing to fit the altered circumstances of the occupational group to which it is applied, either by that group or by extra-group analysis.[36] It is not a process which can be discussed in terms of a set number or type of stages which must be followed if the group is to become professionalised. An occupational group can be said to have begun the professionalisation process when it has formed a discrete body of practitioners. Electrotherapy did this to an extent, with its separate listings in the Trades Directory, but it failed to organise itself into an association whose purpose was solely to protect the occupational group. There is no indication of electrotherapists referring to themselves as professionals; nor did they take any of the steps indicated by some sociological studies as part of the professionalisation process. Paradoxically, the lack of occupational organisation among electrotherapists may have aided this survival. They presented no threatening exclusive front against medical or massage practitioners.

This may serve to highlight the difference between occupational survival and professional survival: an occupation which has established itself, such as electrotherapy in Victoria, survived for a long period without any outward sign of professionalisation. An occupation which claims to be a profession, on the other hand, and which seeks to establish itself, must adopt the outward structures of professionalisation, which in late nineteenth-century Australia included the formation of a professional organisation. In this case, when a mere occupation competes with a rising ‘profession’, the occupation may well lose. This was the case with electrotherapy, which was eventually absorbed by its more successful partner: massage.

B: The Case of Massage, 1880-1906

1. 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 condition of activity and health, and largely by the removal of abnormal deposits by mechanical means.[37]

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.[38] It is worth noting, too, that massage appears to have been preferred as a form of actual medical treatment, rather than as part of post-surgical 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.

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 lady-patients as require the well-considered application of the sort of exercise that is necessary for the recovery of muscles [wasted by disease or sickness].[39]

Early information on massage treatment was available to orthodox practitioners in Australia in the 1880s 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.”[40] 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 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 …. [A]n 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 …. [A]ptitude [is] of more importance than mere muscular strength.[41]

The importance of having a thoroughly trained assistant is hammered home again and again throughout the 1880s in the British Medical Journal.[42] 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 …. [W]hen the general practitioner becomes more familiar with its methods, [it will] take a prominent place in our every-day therapeutics.[43]

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 1890s. Dr J Hamilton, 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.[44][emphasis added]

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 ą friction involved one hand performing centripetal massage while the other disseminated the buildup of pressure, and was considered a more difficult technique.[45] 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. This may have contributed to massage’s survival into the twentieth century, as electrotherapy could not really compete historically on these grounds. 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.[46]

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 the preface to his treatise 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.”[47] 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.[48]

Against this, electrotherapy could stand on ‘science’ as a justification of its practice, but this may have appeared rather sterile in comparison to the antique oriental images of massage. 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.”[49] 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 1890s.[50] 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.[51] 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.”[52] 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”.[53] 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.[54] 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.

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 Australia, there were few within the country who could spare the time or effort to train massage practitioners ‘properly’.[55] 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.[56] 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.

2. Massage as alternative practice

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. 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.

Table 3.1

Massage Practitioners, Major Cities 1891-1905 [57]

        Qld     NSW      Vic    WA      SA 
1891            5       11 
1893            7       20 
1895            5       14 
1897            6       23      1 
1899            14      22      1
1901            13      22      1 
1903 -          24      30      3 
1905    2       35      37      8       1

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.”[58] 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 “agreeable” she is retained on the staff, but if she has conscientious scruples she is discharged and someone is found to take her place. [59]

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.[60]

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 of the attention of our police and our magistrates.[61]

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.[62] 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.

3. 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 state-by-state basis. While Victoria, New South Wales and South Australia had massage associations by 1906, Queensland did not until 1917, and Western Australia did not have a branch at all.[63] Tasmania appears to have had a branch of the Australasian Massage Association from before the Great War, but little evidence survives describing its activity.[64]

Sexual division of labour was significant in early massage practice and organisation. Willis emphasises the importance of gender issues in the establishment of subordinate- dominant roles in the health care system.[65] 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.[66] 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 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.

Notes

1. This definition does not do justice to modern electrotherapy, but it is the most practical for the purposes of discussion. For a more thorough study, see J Low et al, Electrotherapy Explained: principles and practice, Oxford: Heinemann, 1990.

2. W Carey Rees, “On the medical uses of the various forms of electricity”, Australian Medical Journal [AMJ], vol XIX, Sept 1874, p 259.

3. ibid, p 259.

4. AMJ, vol III, 1858, p 313.

5. Rees, op cit, p 258.

6. W Carey Rees, “Some remarks upon a new galvano-faradic apparatus”, AMJ, vol XXII, 1877, p 354.

7. For example, see V Marano, “Case of goitre treated by electricity”, Australasian Medical Gazette [AMG], vol 9, Dec 1889, p 67.

8. T Kendall, “Electro-therapeutics”, AMG, vol 10, August 1891, p 319.

9. A Lurz, “The electric bath and its indication in medicine”, AMG, Oct 1890, p 35. ‘Electric baths’ were a product of the union of electrotherapy and hydrotherapy.

10. Sands Directory, NSW, 1891, p 994. [POD NSW]

11. Sands & McDougall Post Office Directory, Victoria, 1885, p 1001; 1893, p 1277. [POD Vic]

12. Post Office Directory, Queensland, 1889, p 704. [POD Qld]

13. For details of Freeman’s chequered career, see E Ford, Bibliography of Australian Medicine, 1790-1900, Sydney: SUP, 1976, p 86, entry 694.

14. POD Qld, 1892-3, p 830; 1897-8, p 992.

15. POD SA, 1908, ‘massage’; Wise’s Western Australian Post Office Directory, [POD WA], 1904, p 714.

16. POD Qld, 1892-3, p 797.

17. C Eardley-Wilmot, “The action of electricity in disease”, AMJ, vol XIII, n.s., 1891, p 427. The author is described as “lately Assistant Electrician, St Bart’s, Lond.

18. Depending upon the colony in which they practised, the only real stricture involved not advertising as qualified medical practitioners.

19. POD NSW, 1897, p 1156.

20. POD Vic, 1894, ‘Massage’.

21. Kendall, op cit, p 319; Lurz, op cit, p 33; A Peters, Massage: its history, its curative uses, and its practical results, Melbourne: Pater & Knapton, 1890, p 12. See note 47 for details of Peters’ career.

22. AMG, vol 12, 1893, p 1, p 24. The doctors were A Jarvie Hood; A West, LRCS, and Richard Arthur, MD.

23. ibid, p 31; p 126.

24. POD Vic, 1893, p 1277; 1896, p 1323.

25. POD Vic, 1896, p 1323.

26. POD NSW, 1899, p 1204.

27. POD Vic, 1896, p 1323.

28. POD Vic, 1896, p 1323. The majority of these reassuring advertisements could be found in NSW and Victoria.

29. Kendall, op cit, p 317.

30. At the time of the first experiments in galvanism and faradism, there was in fact no such entity as the ‘legitimate’ medical practitioner in Britain. The first Medical Act was not passed in Britain until 1858.

31. Hoerchner in Brisbane moved into herbalism in 1896-7, POD Qld, 1897-7, p 1074; by 1901, Bernard Job was no longer advertising as an electrotherapist but had moved into hydrotherapy, POD NSW, 1901, p 1557; while in Western Australia, Thomas Lovering offered a wide range of treatments at his establishment before finally moving into massage, POD WA, 1904, p 714.

32. Western Argus, (Kalgoorlie), 28.7.1908, p 16; AMG, Aug 1908, p 447.

33. Massage could seriously aggravate existing conditions if wrongly applied: the Medical Journal of Australia reported a case in 1915 of a Sydney woman whose ovarian cyst had been aggravated by several weeks of treatment by “some advertising masseuse who promised to remove the swelling.”, 1915(2), p 195.

34. While real objections were encountered by women who wanted to work in the medical profession itself, there is little to indicate that a similar form of discrimination was experienced by women working in electrotherapy and massage. F Allen, “The expulsion of women from the BMA: the impact on women’s professional aspirations”, in H Gardner, The Politics of Health: the Australian experience, Sydney, 1989, pp 252-277; K Russell, The Melbourne Medical School, 1862-1962, Melbourne: MUP, 1977, pp 48-9, 74-7.

35. Willis, op cit, 1983, p 18.

36. P Martyr, ‘Allied health professionals and the creation of professional history’, Proceedings, Intervarsity Barebones Symposium, Perth: CUPSA,1992, pp. 49-53.

37. L Henry, “Massage”, AMJ, vol VI n.s., Aug 1884, pp 337-8.

38. E Fee, D Porter, “Public health, preventative medicine and professionalization: England and America in the nineteenth century”, in A Wear (ed), Medicine in Society: historical essays, Cambridge: CUP, 1992, p 271.

39. AMJ, 1879, p 180; 1882, p 167.

40. Proceedings of the International Medical Congress, Copenhagen, August 1884, Eighth Session, address to Section of Surgery, reported in the British Medical Journal [BMJ], 1884(2), p 425.

41. W Murrell, “Massage as a therapeutic agent”, BMJ, 1886(1), p 926.

42. See for example BMJ, 28 May 1887, p 1200; 15 Jan 1887, p 113; 4 Feb 1888, p 278; 4 May 1889, p 1001.

43. Henry, op cit, p 347.

44. J Hamilton, “On treatment of lateral curvature of the spine”, Intercolonial Medical Congress of Australasia, 3rd sess, 1892, pp 307-309.

45. Henry, op cit, pp 339-341.

46. J White [‘Shroff’], The Box Seat, or, Medicus and the Shroff, Melbourne: Melville, Mullen, 1900. ‘Medicus’ was Patrick Moloney, MB.

47. Peters, op cit. Alfred and Alex Peters were sons of John Smith Peters, who was described by Alfred as “one of the pioneers of the Massage Treatment in England”. The two brothers worked for several years in partnership in both Perth and Melbourne; Alex from 1895-1899 in Melbourne before coming to Perth, and Alfred from 1891 in Melbourne until 1901, when he appears to have travelled to Perth to work with his brother. They advertised as a joint practice in Perth until 1906, and at the same time Alfred continued advertising in the POD Vic, which serves as an indication of the occasional unreliability of these sources. See also Note 57.

48. ibid, p 6.

49. Henry, op cit, p 337.

50. AMG, vol 9, Feb 1889, p 29; vol 9, Mar 1890, p 148; vol 9, Jul 1890, p 269; vol 9, Sep 1890, p 333.

51. T Wilson, “Cases treated by massage”, AMG, vol 18, 1899, pp 394-5.

52. InterColonial Journal of Medicine and Surgery, vol 5, no 7, July 1900, p xxv. McCormick was honorary masseuse to the Queen Victoria Hospital.

53. ibid, p vi.

54. AMG Advertiser, Feb 15 1895, p 12; AMG Advertiser, Aug 30 1895, pp 10, 13.

55. A Forster, ‘Physiotherapy: a response to challenge’, Australian Journal of Physiotherapy, vol 21, no 4, p 125, claims that Miss Eliza McCauley, a doctor’s daughter, entered the anatomy course at Melbourne University with two female medical students, as well as attending clinics run by Sir Thomas Fitzgerald at the Melbourne Hospital, at some point in the 1890s. See also Russell, op cit, pp 107, 174. If McCauley did practise, she did not advertise herself as a masseuse in the POD Vic. She did not graduate from the medical course, so it is difficult to establish whether she actually underwent any formal training.

56. In the 1890s in Victoria, however, at least two registered medical practitioners advertised as masseurs as well, namely Drs Lurz and Spark, POD Vic, 1892, p 1333. The two continued to advertise until 1896. For details on Lurz’ career, see Ford, op cit, pp 149-50.

57. Based on listings in capital city post office directories. There are, however, caveats involved in using these sources. They were frequently not updated from year to year, and indicate only those massage practitioners who wished to advertise as such. One advantage to this source is that it reveals many unofficial practitioners: the collators relied upon self-description to categorise individuals in trades. There appears to have been no unofficial or official massage practice in Tasmania at this time, although the AMA were able to list two members in Tasmania in 1906. See Note 64.

58. BMJ, 2 Dec 1893, p 1259.

59. BMJ, 14 July 1894, p 88.

60. ibid. 61. BMJ, 21 July 1894, p 145. 62. There is no evidence to indicate that massage was used as a front for prostitution in major Australian cities in this period. See for example R Davidson, “As good a bloody woman as any other bloody woman: prostitutes in Western Australia, 1895-1939”, in P Crawford (ed), Exploring Women’s Past: Essays in Social History, Victoria: Sisters Publishing, 1983, pp 171-201; also C McConville, “The location of Melbourne’s prostitutes, 1870-1920”, Historical Studies, vol 19, 1980-1, pp 86-97; S Horan, ‘More Sinned Against Than Sinning? Prostitution in South Australia, 1836-1914’, BA Hons thesis, unpub, Flinders University of South Australia, 1978, pp 10, 17-18, 20, 46. There is one contemporaneous reference to the scandal of massage parlours in Australia, R Strong, “Therapeutics of massage”, Una Nurses Journal, 30.11.12, p 216.

63. The Australian Physiotherapy Association (WA) branch was formed in the early 1950s.

64. The original archives of this branch appear to have been lost or destroyed, but there are some references to their activity in the archives of other branches.

65. E Willis, Medical Dominance: the division of labour in Australian health care, Sydney: Allen and Unwin,1983, pp 1-2.

66. J Godden, G Curry, S Delacour, “The decline of myths and myopia? The use and abuse of nursing history”, Australian Journal of Advanced Nursing, vol 10, no. 2, December 1992, pp 27-34. See also S Short, E Sharman, “Dissecting the current nursing struggle in Australia”, in G Lupton, J Najman, Sociology of Health and Illness: Australian readings, 1st ed, 1989, pp 230-2.