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The topic says it all. Newspapers could be set in Frank-Rühl with a Linotype machine well enough, and in cold metal, tiny spaces and quads could handle the job of putting vowel points and Masoretic accents below letters.
But it's hard for me to believe that Hebrew, when set with points, was invariably set by hand, and only by hand, until the computer age. My web searches have not pointed me to any information on how Hebrew with points was set, either on a Monotype caster, or with classic photocomposition equipment, but I would think that somehow it was managed.
I could be too optimistic. For Monotype, something like the method used in four-line mathematics would be needed - to retype the line of text when producing accents so as to produce blank slugs of the same width as each letter when an accent was not desired. But then making the accents match their corresponding letters in width would presumably require counting units all the time. The alternative, somehow casting the accent on the same body as the letter, doesn't appear to have been something that would have been considered practical.