Terlouw Thomas J A
J Man Manip Ther. 2007;15(2):E23-41. doi: 10.1179/jmt.2007.15.2.23E.
Physical medicine, which in the context of this article includes mechanotherapy, hydrotherapy, balneotherapy, electrotherapy, light therapy, air therapy, and thermotherapy, became a new field of labor in the healthcare domain in the Netherlands around 1900. This article gives an account of the introduction and development of mechanotherapy as a professional activity in the Netherlands in the 19(th) century. Mechanotherapy, which historically included exercises, manipulations, and massage, was introduced in this country around 1840 and became one of the core elements of physical medicine towards the end of that century. In contrast to what one might expect, mostly physical education teachers, referred to as "heilgymnasts," dedicated themselves to this kind of treatment, whereas only a few physicians were active in this field until the 1880s. When, in the last quarter of the 19(th) century, differentiation and specialization within the medical profession took place, physicians specializing in physical medicine and orthopaedics began to claim the field of mechanotherapy exclusively for themselves. This led to tensions between them and the group of heilgymnasts that had already been active in this field for decades. The focus of attention in this article is on interprofessional relationships, on the roles played by the different professional organizations in the fields of physical education and medicine, the local and national governments, and the judicial system, and on the social, political, and cultural circumstances under which developments in the field of mechanotherapy took place. The article concludes with the hypothesis that the intra- and inter-occupational rivalries discussed have had a negative impact on the academic development of physical medicine, orthopaedics, and heilgymnastics/physical therapy in the Netherlands in the first half of the 20(th) century.
物理医学，在本文语境中包括机械疗法、水疗法、浴疗法、电疗法、光疗法、空气疗法和热疗法，于1900年左右在荷兰成为医疗保健领域的一个新的劳动领域。本文讲述了19世纪机械疗法在荷兰作为一项专业活动的引入和发展情况。机械疗法在历史上包括运动、手法治疗和按摩，于1840年左右在该国引入，并在该世纪末成为物理医学的核心要素之一。与人们可能预期的情况相反，主要是被称为“健康体操师”的体育教师投身于这种治疗，而直到19世纪80年代，只有少数医生活跃在这个领域。在19世纪的最后二十五年，医学专业内部出现分化和专业化时，专门从事物理医学和骨科的医生开始将机械疗法领域据为己有。这导致了他们与已经在这个领域活跃了几十年的健康体操师群体之间的紧张关系。本文的关注重点是跨专业关系、体育和医学领域中不同专业组织、地方和国家政府以及司法系统所扮演的角色，以及机械疗法领域发展所处的社会、政治和文化环境。本文最后提出一个假设，即所讨论的职业内部和职业之间的竞争对20世纪上半叶荷兰物理医学、骨科和健康体操/物理治疗的学术发展产生了负面影响。
