Physicians and healers of all forms and from all cultures have used hands-on manipulation throughout history as an integral part of health care practice. In the former Soviet countries, Germany, Japan, and China, massage has continued uninterrupted as massage therapists today work alongside doctors as part of the health care team.

In modern Germany massage therapy is covered by national health insurance. In China it is fully integrated into the health care system, where the hospitals have massage wards. In one Shanghai hospital the massage department covers two floors.

In this country, the medical use of massage began to diminish in the early part of this century with the evolution of pharmaceutical, surgical, and technological medicine. It reached a nadir in the 1930s, 40s, and 50s because it was considered too time intensive for the modern physician. Massage therapy duties were gradually handed over to aides, who eventually became the physical therapists of the modern era.

The professionalization of massage therapy in the United States began in 1943 when the graduating class of the College of Swedish Massage in Chicago decided to band together and form an association with twenty-nine charter members. What they created was destined to become the American Massage Therapy Association (AMTA).

In the 1960s, while modern medicine continued its march toward higher technology and drugs and away from physician contact with patients, such concepts as holistic health, self-improvement, and optimal health experienced a rebirth. The 1970s brought even greater interest in health promotion and a new openness to massage.

This was followed by explosive growth in the varieties of massage and bodywork available, and today there are now over eighty different varieties. The term "bodywork" evolved as a generic term for referring to this broadening field. It is now loosely used to incorporate massage and other forms of manipulation.

In the survey of alternative medicine that was published in The New England Journal of Medicine in January 1993,¹ massage therapy ranked third among the most frequently used forms of alternative health care. According to Elliot Greene, president of the AMTA, there are now an estimated fifty thousand massage therapists of various kinds in the United States, and the AMTA may be the fastest-growing organization of health care providers m the country. At this writing it has over eighteen thousand members and its rolls have more than doubled in the last three years.