Assault and battery

A report in The New York magazine last week speculated on the likelihood that President Trump might die in office because he is one of the least active presidents in human history (link).

How, you might ask, has this got anything to do with physiotherapy?

Well, the President of the United States, it seems, holds a view about the body, and the detrimental effects of exercise, that was popularised by some of the same 19th century physicians that made physical therapy popular.

It seems President Trump 'considers exercise misguided, arguing that a person, like a battery, is born with a finite amount of energy' (link).

There's a lovely historical overview in The Guardian about this rather arcane notion, and in it we're reminded of the powerful idea that underpinned much of the physical medicine that was the forerunner of our practices today.

In the late 19th century, electrotherapy devices like Galvanic and Faradic batteries were used to restore people's lost energy: the reason we talk about people feeling galvanised, charged up or run down today, for example.  Energy could be lost through mental work, and women were especially vulnerable because so much energy was needed for procreation, that all other forms of mental activity - even from early childhood - were frowned upon.

It is well understood now that such notions were thinly veiled attempts to subjugate an entire gender, concealed beneath the veneer of paternalistic care.  Such attitudes were more than just quaint affectations, and many had profoundly serious effects on the wellbeing of thousands of women.

Hysteria disease and neurasthenia - two of the primary conditions treated by early physiotherapists in Britain and America - primarily affected women, and people like John Harvey Kellogg (of Cornflake and Battle Creek Sanitarium fame) and Silus Weir Mitchell (perhaps America's foremost 19th century neurosurgeon), were pioneers of treatments that supposedly restored women to full health.

Pivotal in Weir Mitchell's treatment regime, known as the Rest Cure, were the passive modalities (massage, passive movements, and electrotherapy) delivered by early nurse/masseuses.  And these modalities endured for the larger part of the 20th century.

Galvanism and, to a lesser extent, Faradism were still being taught in physiotherapy schools into the 1960s, even though they had long since been used for other things than depleting lost nervous energy.  But it seems that ideas about our bodies being stores for certain quantities of nerve 'force' may be harder to shake off.

We should be careful not to be fooled again into thinking that such seemingly benign ideas are not smoke screens for more pernicious and dangerous thoughts and practices.