I have said in my preface that many of the views expressed in these pages will be unorthodox, and my first attempt is to place on record the "reasons for the faith that is in me." This record is based on twelve years' experience of massage and its allied arts, and during that time I have watched the effects of treatment in upwards of six thousand cases of recent fracture alone. The unorthodoxy, where it exists, has therefore been put to a fair test, and, judged by results, its value is readily demonstrated. I hope that I may be forgiven a few personal words in explanation of the origin and growth of my faith.

I owe my first and, as it were, involuntary attempts at massage to the House-Surgeon to Out-patients under whom I first began my clinical experiences as a student. He was discontented with what in his own student days he had seen of the treatment of Colles' fractures; and having heard in the course of his studentship that the after-stiffness of this accident could be prevented to a large extent by so-called "early movement," he proceeded to carry out this theory with more zeal than consideration for the feelings of his patients. Working under his instructions I noted that the patients kept their eyes glued to the injured part and that their preparations for resistance usually commenced long before the movement was attempted. I thought I might do better by placing one hand over the site of fracture, using it as a sort of wristlet for support. Finding my patients still seemed to see each attempt at movement and to resist it accordingly, I next tried passing my hand up and down - not with any idea of rubbing the part, but merely to effect a distraction. Great was my surprise to be greeted by: "Oh, Doctor, that is lovely; do go on." I went on, and I soon discovered that the amount of movement that I had previously attained by the exercise of considerable force, and at the expense of much pain to the patient, was now procured painlessly and without any attempt at force. I watched these cases closely, and soon saw that they improved in what appeared to me then an almost miraculous manner, compared with those who were treated by forced movement, let alone those who were subjected to prolonged splintage.

On receiving my first house appointment I decided to experiment further, and, encouraged by results, successfully extended the treatment to other fractures and injuries. It was at this point that, owing to the kindness of the then Resident Assistant Surgeon at St. Thomas', Mr. J. E. Adams, I was able to make the first tentative trial of instituting a regular clinic for the treatment of out-patients who had sustained fractures. At the end of six months I went to Paris and there commenced my close friendship with the late Just Lucas-Championniere. Though I never saw him treat a patient, I became his ardent disciple; and on my return home I resumed my work with increased zest, when the late Mr. H. H. Clutton kindly assisted me by arranging that I should have full scope for my investigations, and by securing for me the post of Clinical Assistant in the Physical Exercise Department, an appointment thus created for the first time. I now had the opportunity for studying the methods of treatment applied to conditions other than those of recent injury, and formed the opinion that there were two distinct processes in massage: one applicable to recent injury and the other to all cases not coming under this head.

The first thing that made me doubt the integrity of this opinion was a story told me by Championniere, when, on a subsequent visit, I placed my theory before him. There was a masseur in Paris whose name was anathema to the medical world, though the general public formed a different view. His income was the envy of many of the leading medical men of Paris, but his methods he would not divulge. Then his son fell ill - I believe the illness was general peritonitis - and my old friend was consulted. He operated, and devoted himself to the case, which finally resulted in recovery. In gratitude, the masseur for the first time told a medical man the secret of his success. It may be stated in a word: "I never hurt a patient!" That was all, but it started a new line of thought. Since then I have had opportunities of watching various workers - English, French, Swedish, Italian, Danish - and have tried to select all that I saw good, and discard what seemed to be bad, in their methods. The result has been that I sometimes feel that I am rather in the position of a certain lady whose views have been recorded by Walsham How. A minister went to remonstrate with her on the fact that she had forsaken all orthodox forms of worship, and held a service every Sunday for her gardener, James, and herself. He thought, apparently, that the matter could be settled easily by asking whether the old lady really thought that she and James were the only two people who would be saved. He was somewhat taken aback by the answer "Well, I am not so sure about James." Be that as it may, the views expressed in these pages are founded on the result of several years of close observation, study, and experiment. It is possible some of my deductions are erroneous, but at least they are capable of being argued and are not merely arbitrary. The slow but increasing acceptation of many of the principles enunciated now lead me to hope that I may have been able to add something to the advancement of the science of physicotherapeutics.

My hope is that the following pages may be regarded as the outcome of the actual experience of a medical man who has really studied massage, its theory and practice - a being all too rare at the present time. I trust that the record of this experience may help my medical colleagues to understand and to interest themselves in the work of their masseurs,1 besides helping the latter to appreciate more fully the medical man's point of view in connection with the work they are doing for him.

1 Throughout this book the word "masseur" should be regarded as a generic term to include masseur, masseuse, and medical gymnast.