The Challenge of Writing a First Edition with No Previous Texts in the Field
Hydrotherapy, often in combination with massage therapy, has been a basic part of medicine throughout recorded time. For a generation, however-dating from about the early 1940’s to the early 1970’s- both hydrotherapy treatments and massage were dropped from mainstream medicine, and even from much of physical therapy. Then, when massage therapy became increasingly popular with consumers, re-entered mainstream medicine, and created a demand for more massage training programs, a variety of new massage textbooks were written for use in massage therapy programs. Not so with hydrotherapy, however: Despite current research supporting its effectiveness, and new equipment which made it easier than ever to perform, until now there have been no true textbooks on this modality for massage therapists entering the field. The few materials that did exist were basically re-hashing of old books written for doctors or nurses: as such, they covered many diseases and conditions not treated by massage therapists, featured some hydrotherapy treatments which were not even legal for massage therapists to perform, and gave little or no guidance on how to integrate water treatments into massage sessions. Since there were no comprehensive hydrotherapy textbooks which provided current information for today’s massage practitioners, this left massage therapy programs scrambling to find resources, ranging from xeroxed copies of magazine articles and athletic training videos, to outdated nursing textbooks and transcripts of lectures given at naturopathic colleges. After teaching hydrotherapy at a massage school for some years, I could see for myself that the profession badly needed a book which covered not only hydrotherapy’s place in the history of medicine and the latest scientific research pertaining to its effects on the body, but clearly illustrated, step-by-step directions for a wide variety of treatments. After an initial meeting with Lippincott’s editorial team to work out some basic concepts, I set out to write just such a book.
From the beginning, the book was to be comprehensive, covering history, science, current developments in the field, and a wide range of treatments that could be applied to many types of massage clients. It would combine sound physiological principles with a holistic, humanistic approach, as befitting the massage profession. Because there were no previous texts in the field, my first task was to decide what to research and write about, and not surprisingly, there was a great wealth of material on hydrotherapy. My research included extensive reading on the history of medicine (especially the history of massage), public health, specific aspects of human physiology, the science of water, the history of water, the psychology of water, and more. I located and read old textbooks on hydrotherapy, nursing, physical therapy, naturopathy and veterinary medicine, and current physical therapy and athletic training textbooks were consulted as well. I viewed historical footage and films from the early 1900’s through the present, and researched various topics online. Because there was so much material, and because no previous books had already selected what was to be most meaningful for hydrotherapy instruction, I sometimes found myself reading unbelievably obscure items (such as how the ancient Romans stored water in tanks on their rooftops, using pumps operated by slaves running on treadmills, about the history of waterwheels, waterbirths, or the politics of water rights in the American West).
While much could be gleaned from written materials, I also took many field trips to places with hydrotherapy in their past, such as the Warm Springs Rehabilitation Institute, various spas and old hot springs resorts, naturopathic clinics, hospitals where hydrotherapy is used medically, and libraries with collections of illustrations such as the National Library of Medicine in Bethesda, Maryland, and the National College of Naturopathic Medicine in Portland, Oregon. I met with hydrotherapy instructors at massage schools, took a class on spa treatments, and even spent a day in a swimming pool with an aquatic physical therapist. I held interviews with history professors, herbalists, massage therapists, allopathic and naturopathic doctors, authors of scientific studies, toxicologists, nurses, physical therapists and athletic trainers. I also drew on my own experience: for example, I had already written step-by-step directions for a variety of hydrotherapy treatments in my book, Pediatric Massage Therapy (also published by Lippincott). My three decades as a massage therapist provided most of the case studies in the book, and the section on hydrotherapy with terminally ill clients was based in large part on my own work as a hospice massage therapist.
Writing Modern Hydrotherapy for the Massage Therapist
With my research finally completed, I then wrote the first draft of Modern Hydrotherapy for the Massage Therapist. However, once I had completed the first draft, it became obvious that I had over-researched and over-written the book. Basically, there was far more material than would fit in one textbook of this kind. In order to make the book functional, the next step was to decide what to keep in and what to take out. For this task, a team approach was quite helpful, and the book’s first set of reviewers, who included massage educators, massage therapists, and physicians, gave valuable feedback on a variety of issues. The reviewers had a sharp and practical sense of what hydrotherapy instructors, massage students, and practicing massage therapists needed to know about hydrotherapy. They were wonderful fact-checkers as well.
The book’s developmental editor, David Payne, and I then used their feedback to help us decide what information should be left out or kept in the second draft. This proved to be a grueling process, as many fascinating sections containing antecdotes, historical features, case studies and hydrotherapy treatments, all of which had taken up hundreds of hours of my time, had to be deleted. For example, a section which summarized uses of hydrotherapy treatments by other healthcare professionals, such as neurosurgeons, internal medicine physicians, oncologists, nurses, physical therapists, athletic trainers, midwives, physical therapists, chiropractors, athletic trainers and others had to be deleted due to its length. I hated to give up what I thought was a hilarious point of interest box on hydrotherapy treatments that had failed spectacularly, such as the “zotofoam bath” for obesity (imagine being bathed in millions of bubbles made of hot liquid polyethylene foam!), the deadly “sweat stove” treatment for syphilis (the treatment did eliminate syphilis, once the patient died of suffocation or heart failure!), and many others. I wanted to tell the story of the English preacher who had a cold sitz bath installed near his pulpit so he could use it to energize himself before a sermon. And I loved the 1719 poem by English spa doctor Edward Baynard, which satirized the standard medical treatment of patients’ “humors.”
David Payne, editor, and Marybetts reviewing photographs at the photo shoot for Modern Hydrotherapy for the Massage Therapist |
However, as work on the book progressed, it became more obvious that too many anecdotes, fascinating as they might be to some, would make the history chapter long and cumbersome, and would actually be more suitable in a work on the history of medicine. Other sections with specialized information were also interesting, but simply “too much information” for the beginning student. As for hydrotherapy treatments themselves, treatments that were not clearly in scope had to be deleted, as well as those that required very expensive or specialized equipment, those that looked promising but were supported by only weak research, and treatments that were too rigorous for the average client. In the end, more than a third of the original draft had to be cut, and the 200-odd references contained in the final work reflect only a small portion of the original ones. Yet clearly, the manuscript was greatly improved: it was now more concise, more readable, and better focused on focused on the essential information hydrotherapy instructors and students needed to have. A second set of expert reviewers then went through the second draft, offering more valuable suggestions on content and accuracy. A third and final draft was then completed using feedback from them as well as from the book’s editor, David Payne, resulting in an even better book.
Illustrations
Illustrations were yet another challenge. Since there were no current hydrotherapy textbooks for massage therapists, and older nursing and physical therapy books which contained hydrotherapy information had very outdated illustrations, we had no good models for illustrations either. We were fortunate to find a wonderful professional photographer, Mount Burns, suitable locations at spas and massage schools, and a variety of models of different ages, body types, and sexes. Our emphasis was on clear, uncluttered depictions of real people giving and receiving hydrotherapy treatments in the context of a massage session, and the final illustrations do just that.
This pioneering first edition of Modern Hydrotherapy for the Massage Therapist is now ready for use in massage therapy training programs. It is truly the book I wish I had had when I was a young massage student, and when I first began teaching hydrotherapy. It is packed with information and great features, and contains many clearly illustrated treatments which can be given before, during or after massage sessions. It will provide massage therapy programs with the information to bring hydrotherapy back to its traditional partnership with massage, in a way that works in today’s massage therapy climate.
