Oil, Exercise and the Healing Hand: Therapeutic Touch in the Ancient World

Jan 16, 2025

12 min read

Updated: Aug 22

Before massage had a treatment couch, a clinic room or even a name that we would recognise, it belonged to very different worlds.

In ancient Mesopotamia, rubbing could be performed while incantations were spoken over oil. In a Greek gymnasium, an athlete’s body was anointed before exercise and scraped clean afterwards. Roman physicians debated how the pressure, duration and direction of rubbing altered the body, while medical manuscripts from early China placed assisted touch alongside movement, breathing, diet and other methods of nurturing life.

These practices are often gathered together under the modern heading of “massage”, but the word can conceal as much as it reveals. Ancient writers spoke instead of rubbing, friction, anointing, pressing and manipulation. Nor did these traditions form a single, continuous line of development. Mesopotamian, Greek, Roman and Chinese healers worked within different cultures and understood the body in fundamentally different ways.

What connected them was simpler: the recognition that touch could be used deliberately—as part of bodily care, preparation for exertion, treatment after injury, the application of medicines or a ritual response to illness.

Mesopotamia: Rubbing, Oil and Incantation

Our story begins long before Hippocrates, not in a Greek consulting room but among the cuneiform tablets of ancient Mesopotamia.

Mesopotamian healthcare drew upon plant and mineral preparations, oils, bandages, fumigation, incantations and ritual actions. The categories of “medicine” and “magic”, which seem distinct to us, did not necessarily describe separate forms of treatment. A medicinal substance could be prepared practically, activated through spoken words and applied through a prescribed bodily action.

One of the clearest examples is the Muššuʾu, a title usually translated as “rubbing” or “anointing”. Surviving first-millennium BCE ritual instructions begin with incantations recited over oil and salve. The practitioner then works progressively over the patient’s body: rubbing the temples and forehead, neck, hands, abdomen, hips, legs and feet. Cedar extract is applied from head to toe, while amulets, incense and water are incorporated into the wider healing ritual (Böck, 2003).

This was more than the application of oil accompanied by a prayer. The spoken words, medicinal substances, movements of the hands and symbolic objects formed a single therapeutic event. Illness might be associated with a god, ghost, demon, broken oath or other disturbance, but treatment could still involve close observation of symptoms and the physical preparation and application of remedies (Geller, 2010).

Rubbing was therefore both a practical action and a means of directing the ritual against the affliction. The hands moved over the affected body while the incantations identified, confronted and attempted to expel the source of illness.

The Muššuʾu provides one of the ancient world’s most striking accounts of therapeutic touch. It also warns us against interpreting past treatments through modern divisions between the physical, psychological and spiritual. For a Mesopotamian healer, these were not necessarily separate dimensions of care.

Greece: The Oiled Body

Several centuries later, rubbing occupied a very different setting in ancient Greece: the gymnasium.

Picture an athlete arriving with a small flask of olive oil. Before training, the oil was spread across the skin. Exercise took place in a world of running, wrestling, boxing and throwing, after which accumulated oil, sweat and dust could be removed with a curved metal scraper called a strigil. Washing, further anointing and rubbing might follow.

These practices were not equivalent to a modern sports massage. Oiling belonged to a wider culture of bodily preparation, cleanliness, appearance and athletic identity. Gymnasia were places of physical education and social life as well as exercise, and care of the body carried civic, aesthetic and sometimes religious meanings.

The people responsible for training could also supervise diet, exercise, anointing and recovery. The boundaries between coach, physical educator and medical practitioner were not yet sharply drawn. It was from this world that Herodicus of Selymbria emerged.

Herodicus: When Physical Training Became Medicine

Herodicus lived during the fifth century BCE and combined the roles of gymnastic trainer and physician. None of his writings survives, so his ideas must be reconstructed from later authors—some of whom were far from sympathetic.

He regarded health as dependent upon a carefully regulated relationship between food and physical activity. Exercise was not reserved for athletic competition: it could be prescribed as part of treatment. Walking, wrestling, bathing and other forms of physical training were incorporated into a demanding regimen intended to preserve or restore bodily balance (Georgoulis et al., 2007).

Plato later portrayed Herodicus as a sickly trainer who combined gymnastics with medicine and spent his life following an exacting health regimen. The description in the Republic is satirical, presenting him as someone who prolonged both his illness and his life through constant attention to his body (Plato, Republic 406a–c).

The criticism is revealing. Herodicus represented a new and potentially controversial kind of healthcare: one that asked the patient to participate continually through diet, movement and disciplined habits. His lasting importance lies in bringing the practices of the gymnasium into medicine and treating physical activity as something that could be prescribed, adjusted and monitored.

He is frequently called the “father of sports medicine”, although that is a modern title rather than an ancient one. More significantly for the history of therapeutic touch, his work belonged to an environment in whichHerodicus were increasingly considered parts of a regulated approach to health.

Hippocratic Medicine: The Physician’s Hands

Herodicus is often described as the teacher of Hippocrates, although the precise relationship remains uncertain. What is clearer is that rubbing acquired an important place within the medical writings associated with Hippocrates.

Hippocrates of Kos was a historical physician who lived during the fifth and fourth centuries BCE, but the approximately sixty works traditionally gathered under his name were written by several authors over a considerable period. It is therefore more accurate to speak of the Hippocratic Corpus or Hippocratic medicine than to assume that every surviving instruction came directly from Hippocrates himself.

Within these writings, touch served several purposes. The physician used the hands to feel heat, swelling, movement and changes in bodily tissues. Rubbing could accompany exercise, bathing and the application of oil, but it could also form part of treatment after injury.

In On Joints, for example, the author describes care following the reduction of a dislocated shoulder. The shoulder is to be rubbed gently with soft hands and moved carefully without provoking pain. The passage shows that rubbing was not imagined simply as a vigorous or general treatment. Its force and movement were expected to respond to the condition of the injured part (Hippocrates, On Joints 9).

A later Roman writer, Celsus, preserved a concise formulation attributed to Hippocrates: hard rubbing was thought to bind, soft rubbing to loosen, prolonged rubbing to diminish and moderate rubbing to build up the body. These terms described the qualities ancient physicians believed could be produced within bodily tissues. They did not refer to strengthening muscles or increasing circulation in the modern physiological sense.

Hippocratic medicine understood health through qualities such as hot and cold, wet and dry, dense and relaxed. Rubbing generated warmth and movement and could therefore be varied according to the patient, the condition and the intended effect. Its use depended upon judgement rather than a fixed routine.

This is perhaps the most recognisable element of the Hippocratic approach. The value of touch lay not in performing the same sequence on every person, but in adapting pressure, duration and movement to the body being treated.

From Greece to Rome: Friction Becomes a Medical System

As Greek medicine entered Roman life, rubbing became increasingly visible within written accounts of general healthcare.

One influential figure was Asclepiades of Bithynia, a Greek physician who established a successful practice in Rome during the late second and early first centuries BCE. He rejected important elements of conventional humoral medicine and instead imagined the body as composed of particles moving through pores. Health depended upon their free and orderly motion, while illness resulted from obstruction or excessive relaxation.

His preferred treatments included diet, bathing, exercise, passive movement and friction. Rather than relying immediately upon powerful drugs, he attempted to alter the patient’s bodily state through carefully managed aspects of daily life.

Asclepiades’ own writings are lost, but his approach is described by Aulus Cornelius Celsus in De Medicina, written during the early first century CE. Celsus observed that Asclepiades had discussed friction more fully and clearly than earlier physicians, particularly in relation to when and how it should be used. Celsus then devoted an entire chapter to the subject, considering the patient’s age, strength, illness and bodily condition alongside the duration and intensity of treatment (Celsus, On Medicine 2.14).

Friction was not presented as a universal remedy. Celsus distinguished between the treatment of the whole body and attention to a particular part, and between rubbing intended to support health and rubbing used during illness or recovery. He also recognised that the same treatment could affect different bodies in different ways.

By this point, therapeutic rubbing had moved beyond the gymnasium without leaving it behind. It remained associated with exercise and bathing, but it had also become part of a physician’s repertoire—something to be prescribed with attention to timing, dosage and individual constitution.

Galen: From the Gladiatorial School to On Health

No ancient physician developed these ideas more extensively than Galen of Pergamum.

Born in 129 CE, Galen studied medicine across the eastern Mediterranean before returning to Pergamum, where he was appointed physician to a school of gladiators. The role placed him in direct contact with wounds, fractures, dislocations and the physical consequences of strenuous training. It demanded practical skill as well as theoretical knowledge.

The image of Galen tending injured gladiators is compelling, but his importance extends far beyond the arena. He later moved to Rome, treated members of the imperial household and produced an enormous body of writing on anatomy, physiology, drugs, diagnosis, exercise and the preservation of health.

In On Health, Galen placed rubbing within a daily regimen that also included food, sleep, exercise and bathing. He discussed preparatory treatment before activity and restorative treatment afterwards. Pressure, duration, speed and direction could all be adjusted, while oil helped the hands move quickly and reduced the harshness of the contact.

Galen inherited the distinction between hard, soft, prolonged and moderate rubbing, but expanded it into a more elaborate system. The practitioner needed to consider not only what was done, but to whom, for how long and at what stage of exercise or recovery. A pressure that felt firm to one person might be comparatively gentle to another (Galen, 2023).

His explanations remained grounded in ancient physiology. Rubbing was thought to heat the body, alter its density, disperse residual substances and change the condition of the flesh. Oils could also be chosen according to their presumed warming, cooling, drying or dispersing qualities.

These ideas should be understood on their own terms. Galen knew nothing of blood circulation as it would later be described by William Harvey, and his “residues” were not modern metabolic waste products or lactic acid. Nevertheless, his insistence that rubbing should be graded according to the person, purpose and response gave therapeutic touch an unusually systematic place within medicine.

Galen’s writings would shape medical thought for well over a thousand years. When later Arabic- and Latin-speaking physicians discussed friction, exercise and health, they were frequently working with ideas that he had organised and transmitted.

Han China: Touch Within the Art of Nurturing Life

While Greek and Roman physicians were developing their systems around the Mediterranean, distinctive traditions of bodily care were taking shape in early imperial China.

The evidence reaches beyond the biographies of famous physicians. Manuscripts excavated from tombs provide direct glimpses of practical healthcare during the centuries around the formation of the Han Empire.

Medical texts placed in a tomb at Mawangdui in 168 BCE describe a diverse world of remedies, bodily techniques, movement and the cultivation of health. Rubbing and assisted manipulation appear alongside medicines, heat treatments and exercises. These texts predate the fully developed medical system often retrospectively presented as a single, timeless form of “traditional Chinese medicine” (Harper, 1998).

A further manuscript, the Yinshu or Pulling Book, was buried at Zhangjiashan at approximately the same time. It contains instructions for daoyin—literally “guiding and pulling”—a varied practice involving movement, stretching, posture and breath. Some exercises imitated animals, while others responded to particular physical complaints.

The Yinshu places these practices within yangsheng, the broader art of “nurturing life”. Exercise was coordinated with washing, grooming, diet, sleep, sexual behaviour and the changing seasons. As in Greek and Roman regimen, bodily movement did not stand alone but belonged to a larger way of organising everyday life (Lo, 2014).

By the later Han period, the physician Hua Tuo had become associated with one of the most famous exercise traditions in Chinese medical history: the Five Animals. The sequence imitated the tiger, deer, bear, ape and bird, using their movements to mobilise different parts of the body. Hua Tuo reportedly compared regular movement to a door hinge that does not decay because it continues to move.

The Five Animals was a form of daoyin rather than massage. Its relevance lies in the wider therapeutic culture to which both practices belonged. Guided movement, breath, self-rubbing and touch administered by another person could all form part of efforts to maintain bodily function and respond to illness.

These practices were often explained through qi, but translating qi simply as “energy” can be misleading. In early Chinese medicine, it encompassed vital and material processes associated with breath, nourishment, movement, climate and bodily transformation. Rubbing, exercise and breathing could be understood as ways of influencing these processes, rather than manipulating an invisible energy in the modern popular sense.

Hua Tuo’s later reputation also reminds us that histories of medicine often gather complex traditions around memorable individuals. As Miranda Brown (2015) has shown, the celebrated “fathers” of Chinese medicine were shaped not only by their lives, but by generations of biographers, editors and historians who used them to tell a coherent story about the origins of healing.

What Did Therapeutic Rubbing Mean in the Ancient World?

There was no single ancient explanation for why rubbing worked. A Mesopotamian healer might use touch to apply a medicinal substance while directing an incantation against the cause of an affliction. A Hippocratic physician might seek to warm, soften or bind a particular part. Asclepiades understood friction through the movement of particles and pores, while Galen interpreted its effects through bodily qualities, innate heat and the dispersal of residues. In early China, rubbing belonged to a changing landscape of bodily techniques concerned with movement, breath, qi and the nurturing of life.

Nor was therapeutic touch always a treatment for illness. It prepared bodies for exercise, helped mark the transition from exertion to rest, applied oils and ointments, and formed part of bathing and personal care. In the management of injuries, it sat alongside examination, movement, reduction, bandaging and rest.

The surviving evidence is also uneven. Written medicine largely preserves the ideas of educated male authors, while many ordinary acts of care left no record. The person performing the rubbing might have been a physician, trainer, bath attendant, household servant, relative or another healer whose name was never written down.

What emerges is not a single ancient profession, but a family of practices crossing medicine, physical training, hygiene, ritual and domestic care.

Why This History Still Matters

The longevity of therapeutic touch does not, by itself, prove a modern clinical claim. Ancient physicians did not discover blood circulation, lymphatic drainage, muscle physiology or the nervous system through massage. Their treatments were interpreted through medical systems very different from our own, some of which included assumptions that have long since been abandoned.

What their writings reveal is an enduring set of practical questions.

How should touch be adapted to the person? When is firmer pressure appropriate, and when should treatment be gentle? How might the body be prepared for exertion or allowed to settle afterwards? How do movement, rest, environment and daily habits influence the experience of health? What happens when the act of treatment also provides reassurance, attention and care?

The answers available to an ancient Mesopotamian healer, a Hippocratic physician, Galen or a Han practitioner were shaped by their own cultures. The questions, however, remain surprisingly familiar.

Modern massage therapy is not an unchanged survival from antiquity. Its techniques, professional identities and explanations have been repeatedly reconstructed. Yet beneath those transformations lies a recognisable human act: one person using informed, purposeful touch in an attempt to help another.

From the ancient world, these practices would pass into new languages and intellectual traditions. Greek medical works were preserved, criticised and developed by physicians writing in Arabic, while rubbing, anointing and manipulation continued in households, bathhouses, monasteries and surgical practice.

That journey—from Avicenna’s Canon to the medical transformations of the Renaissance—forms the next chapter in the history of therapeutic touch.