Gerry and I were in Louisville, Kentucky, for the ASI convention, the annual gathering of independent and self-supporting Adventist ministries. One lady who came by the booth said she had greatly appreciated Dr. Iskander’s article on massage, and had printed it out and given many copies away. She urged me to re-post this important article. So, by request, here is Elizabeth’s article on massage—DCR
Many Seventh-day Adventists are unaware that Ellen White believed in the health benefits of massage. Both in her writings and through her personal example, she taught that massage was part of the medical missionary work and part of a healthy lifestyle.
a. The Writing and Example of Ellen White
In reading Ellen White on this topic, one must be aware that the terms “Swedish movement cure,” “movement cure,” and “manual Swedish movement,” are 19th Century terms for what today is called Swedish Massage, relaxation massage, classic massage, or just massage.
In the June 1, 1873, edition of the “Health Reformer,” White wrote that because women no longer engaged in strenuous domestic labor, as our ancestors once did, massage is a necessity now:
“A woman who did all these [domestic tasks], and diversified the intervals with spinning on the great and little wheel, did not need the gymnastics of Dio Lewis, or the Swedish movement cure, which really are a necessity now. Does it not seem poor economy to pay servants for letting our muscles grow feeble, and then to pay operators to exercise them for us?” Health Reformer, June 1, 1873, par. 11 (emphasis added).
White taught that massage can be “a great advantage” for a class of people who are too ill for autonomous exercise; however, even sick people should not lean on massage to the exclusion of exercise:
“Exercise, to be of decided advantage to you, should be systematized and brought to bear upon the debilitated organs that they may become strengthened by use. The movement cure is a great advantage to a class of patients who are too feeble to exercise. But for all who are sick to rely upon it, making it their dependence, while they neglect to exercise their muscles themselves, is a great mistake.” Testimonies, vol. 3, p. 76 (1 MCP 120.1)
It is possible to do too much massage just as we can overdo other physical activities, such as weight training, which White calls “the lift cure”:
“I was instructed that there is great danger of overdoing the lift cure, the massage, and the testing to see who can excel in expanding their lungs to the utmost capacity.” 3 MR 366.1
It seems that the importance of massage therapy crystalized for Ellen White during her nine-year sojourn in Australia. In counseling on the plans for the Sydney Hospital, she wrote that the bathrooms should be large enough to encompass facilities for treatments such as massage:
“The bathroom should be a room where massage and other treatments can be given. This part of the building should in no case be crowded out. There should be two bathrooms, one for lady patients, the other for the men.” 16 MR 245.3
“Some matters have been deeply impressed upon my mind, and one is the necessity for much better facilities in the bathrooms. This is where impressions will be made upon minds. We must have conveniences in these rooms—massage tables, and a cot on which to give packs.” Paulson Collection, p. 15.5
In 1896, a Battle Creek College graduate, A.W. Semmens, and his wife opened a “Health Home” in Sidney, Australia. Ellen White supported this medical missionary effort both monetarily and with counsel. Advertisements for the Health Home stated:
“These diseases will be treated by the most approved methods of hygiene, hydrotherapy, electrotherapy, massage, manual Swedish movement, diet, et cetera. Electric baths, electric vapor baths, sitz baths, salt glows, hot packs, wet sheet packs, massage, et cetera, can be had.”
Mrs. Semmens was a trained masseuse: “Sister Semmens has received her education in giving treatment to the sick without administering drugs. She gives massage and other hygienic treatment.” Letters, Dec. 29, 1896.
It is interesting that Ellen White, during her years in Australia, regularly received massages as part of her personal health regimen. Her masseuse was a lady named May Walling, who was well paid for her services:
“Our expenses have been unavoidably large. . . . [expenses listed] Besides this, I pay May Walling four dollars per week. She has to stand as matron in the kitchen and give me treatment when I need it—a massage or rubbing once per day, general bath once per week.” Letter, Sept. 22, 1892, par. 6.
A few years later, White counseled that Walling be given a full-time position at the Health Retreat:
“I have just written May Walling a letter advising her to connect with the Health Retreat. She is indeed the best hand to give treatment I have ever seen in all my experience. I have had many work over me, but none who could do as good work. I wish to have her connect with the Health Retreat and not be drifting about here and there and everywhere. She has knowledge in giving massage that she practices thoroughly.” Letter, May, 16, 1895.
After returning to the United States, Sister White continued the practice of taking massages:
“Ella May is a faithful caretaker and nurse. She neglects nothing that she or I know how to do. I appreciate her. She has given me most faithful massage and rubbing and is at hand to do anything. I am surprised that she does so well.” Letter 353, Aug. 27, 1905.
The record is clear that Ellen White counseled that massages be provided at our Adventist hospitals and sanitariums, and regularly received massages herself.
b. The Confirmation of Science
So what does modern science say about the effects of massage? Do massages have real value, or is “the Swedish movement” one of those 19th Century fads that we now know lacked medical efficacy?
i. Boosting the Immune System
First and perhaps most surprisingly, there are several studies that indicate that massage boosts the body’s immune system. A recent study[i] at Cedars-Sinai Medical Center in Los Angeles found that massage increased the production of lymphocytes, the white blood cells that attack and destroy invading pathogens. In the study, a treatment group of 29 participants received 45 minutes of Swedish massage, and a control group of 24 received “light touching,” but not massage. Blood samples were taken at several intervals before, during, and after the massage. In addition to increased white blood cell count, the treatment group registered lower levels of Arginine Vasopressin (a substance that constricts blood vessels), cytokines (small proteins associated with inflammation), and the stress hormone cortisol.
“This research indicates that massage doesn't only feel good, it also may be good for you,” said principal author Mark Rapaport. “People often seek out massage as part of a healthy lifestyle but there hasn’t been much physiological proof of the body’s heightened immune response following massage until now.”
ii. Hormonal Changes and Better Sleep
A study published in 2005 in the International Journal of Neuroscience found that massage reduces levels of cortisol by an average of 31%, while boosting the well-being/euphoria hormones serotonin (by an average of 28%) and dopamine (by an average of 31%).[ii] Less cortisol and more serotonin and dopamine also mean less stress, anxiety, and depression, as they slow the heart rate, reduce blood pressure, and block the nervous system’s pain receptors.
These results also help explain the heightened immune system observed both in the Cedars-Sinai study, and in other studies. “We know that cortisol destroys natural killer cells [lymphocytes],” says principal author Tiffany Field. “Therefore, since massage decreases cortisol, your immune cells get a boost.” The immunity-boosting effect of massage has been observed even in patients with compromised immune systems, including women with breast cancer[iii] and AIDS patients.[iv]
A good massage also helps you relax and sleep. The heightened level of serotonin reported in association with massage not only fosters a sense of wellbeing and contentment, it also promotes the synthesis of melatonin—the hormone that puts you to sleep—because serotonin is a metabolic precursor of melatonin. Additionally, massage increases Delta Waves—the longer brain waves linked to deep sleep.[v] Somewhat paradoxically, at least one study found that a 15-minute upright “chair massage” boosted alertness and improved mathematical computation performance.[vi]
iii. Oxytocin and Social Bonding
A recent study[vii] explored how massage facilitates the release of oxytocin. Oxytocin is a neurotransmitter that plays a role in many social, emotional, and behavioral human functions. It is increasingly being studied for its potential applications in several attention-related and socio-behavioral dysfunctions, and is known to have a variety of positive and powerful effects for humans’ emotional and social development, particularly emotional bonding.
The study monitored the direct effects of massage, including the release of oxytocin, beta-endorphin, nitric oxide, and adrenocorticotrophin hormone (ACTH). Ninety-five people participated in the study, divided into a treatment group of 65 and a control group of 30. Blood was drawn from both groups, then the treatment group received 15 minutes of moderate-pressure massage in the upper-back region, while the control group merely rested quietly. Then blood was drawn again. As compared to the control group and pre-massage levels, the treatment group had higher levels of oxytocin and lower levels of ACTH, nitric oxide, and beta-endorphin. This study provides the first solid empirical evidence that massage increases oxytocin.
Oxytocin plays a role in bonding, as it is released during physical acts of affection such as hugs and kisses, as well as when a mother is nursing her baby, and is associated with higher levels of emotional attachment and fidelity. Accordingly, women should be massaged by women, and men by men; mixed-sex massage should be limited to husbands and wives, who should massage each other as a way of bonding and increasing marital intimacy. Mixed-sex massage in a therapeutic setting should be avoided:
“In no case should women nurses give treatment or massage or packs to men, or men to women. Let everything in the bathroom be done decently and in order.” MS 68, April 14, 1899.
c. Massage is Therapeutic and Should be in Our Hospitals
The evidence is unequivocal: massage is not just a 19th Century fad, but real, beneficial therapy. It should be part of everyone’s health routine, along with water, fresh air, exercise, rest, and a healthy diet.
Massage should be restored to its rightful place in Adventist hospitals, per the counsel “deeply impressed” upon the mind of Ellen White. Massage’s proven efficacy in boosting the immune system is critical in a hospital setting, both because it is easy to contract an infection in a hospital—there are a lot of sick people in hospitals, oddly enough—and because some patients are suffering from conditions (e.g. AIDS) or are undergoing treatments (e.g., chemotherapy, radiation therapy) that compromise their immune systems.
In addition, the clinically demonstrated ability of massage to increase levels of the “feel good” hormones serotonin, dopamine, and oxytocin, natural analgesics, should reduce the demand for pain pills, and reduce the anxiety that some hospital patients experience. Because serotonin metabolizes into melatonin, which induces sleep, fewer patients should need hypnotic and soporific medications in order to achieve restorative sleep.
Massage therapy in a hospital setting, considering its benefits and its enhancement of patients’ experience, would be very cost effective. It is time for our hospitals to return to the counsel of our pioneer health reformer, who was a messenger of the Great Healer himself. Our hospitals would soon develop a reputation for greater patient satisfaction and positive clinical results that would distinguish them from their competitors.
[i] Rapaport, M.H., Schettler, P., Breese, C., “A preliminary study of the effects of a single session of Swedish massage on hypothalamic-pituitary-adrenal and immune function in normal individuals,” J Altern. Complement Med. 2010 Oct;16(10):1079-88.
[ii] Field T., Hernandez-Reif M., Diego M., Schanberg S., Kuhn C., “Cortisol decreases and serotonin and dopamine increase following massage therapy,” Int. J. Neurosci. 2005 Oct;115(10):1397-413
[iii] Hernandez-Reif M., Field T., Ironson G., Beutler J., Vera Y, Hurley J, Fletcher MA, Schanberg S, Kuhn C, Fraser M., “Natural killer cells and lymphocytes increase in women with breast cancer following massage therapy,” Int. J. Neurosci. 2005 Apr;115(4):495-510; Hernandez-Reif M, Ironson G, Field T, Hurley J, Katz G, Diego M, Weiss S, Fletcher MA, Schanberg S, Kuhn C, Burman I., “Breast cancer patients have improved immune and neuroendocrine functions following massage therapy,” J. Psychosom. Res. 2004 Jul;57(1):45-52.
[iv] Diego M.A., Field T., Hernandez-Reif M., Shaw K, Friedman L, Ironson G., “HIV adolescents show improved immune function following massage therapy,” Int. J. Neurosci. 2001 Jan;106(1-2):35-45
[v] Diego M.A., Field T, Sanders C, Hernandez-Reif M., “Massage therapy of moderate and light pressure and vibrator effects on EEG and heart rate,” Int. J. Neurosci. 2004 Jan;114(1):31-4 (“The moderate massage group also experienced a decrease in heart rate and EEG changes including an increase in delta and a decrease in alpha and beta [brainwave] activity, suggesting a relaxation response.”)
[vi] Field T., Ironson G, Scafidi F, Nawrocki T, Goncalves A, Burman I, Pickens J, Fox N, Schanberg S, Kuhn C., “Massage therapy reduces anxiety and enhances EEG pattern of alertness and math computations,” Int J Neurosci. 1996 Sep;86(3-4):197-205.
[vii] Morhenn, V, Beavin, L.E., Zak, P.J., “Massage increases oxytocin and reduces adrenocorticotropin hormone in humans,” Altern. Ther. Health Med. 2012 Nov-Dec;18(6):11-8.