72 8 THE POPULAR SCIENCE MONTHLY. 



adipose, modes of life, exercise, etc. A frequent error on the part of 

 manipulators is in attempting to stretch the tissues in opposite direc- 

 tions at the same time, especially at the flexures of the joints, where 

 the skin is delicate and sensitive, and where the temptation to such 

 procedures is greatest because easiest, the effect being a sensation of 

 tearing of the skin. The rate of these manoeuvres varies from 

 seventy-five to one hundred and fifty with each hand per minute on 

 the arms, from sixty to ninety on the legs, and from forty to eighty 

 on the thighs, where more force is required on account of the larger 

 size and density of the muscles, and the need of using sufficient force 

 to extend beneath the strong, tense fascia lata. 



On the back the direction of these efforts will be from the base of 

 the skull downward, stretching the tissues away from the spinal 

 column while manipulating in graceful curves at an average rate of 

 sixty per minute with each hand. And here one hand can often be 

 re-enforced by placing the other upon it, and thus massage may be 

 done with all the strength the manipulator can put forth. "With the 

 ends of the fingers the muscles on each side of the spinal column can 

 be rolled, and the supra-spinous ligament can be effectually masseed 

 by transverse to-and-fro movements. The ends of the fingers and 

 part of their palmar surface should also be placed on each side of 

 the spinous processes, and the tissues situated between these and the 

 transverse processes worked upon by up-and-down motions parallel 

 to the spine, taking care to avoid the too frequent error of making 

 pushing, jerky movements in place of smooth, uniform motions in 

 each direction. 



On the chest and abdomen the same general direction will be ob- 

 served as in using friction, but the manipulation will be more gentle 

 than on the back and limbs, for the tissues will not tolerate being so 

 vigorously squeezed and pinched. Here the massage will consist of 

 moderate pressure and movement with the palms of the hands, and 

 rolling and grasping the skin and superficial fascia ; and, after this, 

 on the abdomen, steady, firm, deep kneading in the direction of the 

 ascending, transverse, and descending colon, using for this purpose 

 the greatest force with the heel of the hand on the side of the abdo- 

 men next the operator, and on the other side the strongest manipula- 

 tions with the fingers, avoiding the frequent and disagreeable mistake 

 of pressing at the same time on the anterior portions of the pelvis. 



Before leaving this part of the subject, the writer begs leave to 

 say something more about the common errors into which manipulators 

 fall, even some of those who pass for being skillful. Many do not 

 know how to do the kneading or malaxation with ease and comfort to 

 themselves and to their patients, for, in place of working from their 

 wrists and concentrating their energy in the muscles of their hands 

 and fore-arms, they vigorously fix the muscles of their upper arms 

 and shoulders, thus not only moving their own frame with every 



