Tuina, also known as massage, involves applying various manual techniques on the skin, muscles, and acupoints to achieve health preservation and therapeutic purposes. It can be performed by others or self-administered—self-massage means massaging oneself.
Using tuina for disease prevention, treatment, and health preservation has a long history in China, dating back thousands of years, with high regard from Chinese medical and health preservation experts. For example, *Huangdi Neijing* states: “Do not cease massage; do not disdain acupuncture; transfer qi to deficiency; spiritual qi will recover.” This indicates that by the Qin-Han period, tuina had already become an essential medical and health-preserving method. In the Jin Dynasty, Ge Hong’s *Baopu Zi·Inner Chapters·Far Reaches* mentioned a lost *Ten Volumes of Massage and Guiding Exercises*. However, excerpts from the *Guiding Exercises* were preserved in *Yangxing Yanming Lu*, stating: “In the morning, rub both palms until warm, then wipe the eyes three times. Next, scratch the corners of the eyes four times to keep eyes bright. ... Also, warm the hands and rub the face from top to bottom to remove evil qi and give the face a radiant glow. ... Also, warm the hands and rub the body from top to bottom—called dry bathing—which resists wind, cold, seasonal illnesses, headaches, and all diseases.” These contents from the *Guiding Exercises* were widely cited and praised in many later texts. In the Sui Dynasty’s *Zhubing Yuanyou Lun*, each chapter ends with guidance and massage methods. Self-massage became widespread at the time, reflecting the emphasis on prevention and encouraging patients’ active participation in fighting illness. During the Sui and Tang dynasties, medicinal ointments were applied to the body surface during massage, leading to the development of *Gao Mo* (ointment massage)—a method that prevents skin damage and synergistically combines drug and manual effects. Various ointments existed, including Mangcao Ointment, Dangshen Ointment, Wutou Ointment, Yegé Ointment, Chen Yuan Ointment, and Muduwei Ointment—selected according to condition. Ointment massage was also used for pediatric care. *Qianjin Yaofang* states: “Even if children have no illness, early morning application of ointment to the fontanelle and palms/soles can prevent wind-cold.” By this period, specialized massage clinics existed, with titles such as Massage Doctor and Massage Therapist, indicating the popularity of massage. Notably, renowned physician Sun Simiao greatly praised massage and guiding exercises. In *Beiji Qianjin Yaofang·Yangxing*, he wrote: “Massaging three times daily, after one month, all diseases vanish, and one can run faster than horses—this is the method of health preservation.” This statement both inherits pre-Tang health wisdom and reflects his personal experience, exerting great influence on later generations.
During the Song, Jin, and Yuan dynasties, tuina’s applications expanded further. For example, Song Dynasty physician Pang Anshi treated patients with nearly 90% success rate. One case involved a woman in labor who had not delivered for seven days despite all remedies. He instructed her family to warm her waist and abdomen with hot water and perform self-massage. She felt slight intestinal pain and gave birth to a boy—a successful use of massage for labor induction. In *Yanglao Fengqin Shu* by Chen Zhi of the Song Dynasty, it was advised that elderly people frequently rub Yongquan to maintain light steps and vitality in old age.
In the Qing Dynasty, the main development in health-preserving tuina was the proliferation of pediatric tuina literature—rich content, illustrated, simple techniques, widely circulated in folk communities.
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