MASSAGE. 729 



manipulation, but also that of their patients, giving to the latter a 

 motion and sensation as if they were at sea in stormy weather. By 

 this display of awkward and unnecessary energy, not only do they 

 soon tire themselves, and say that they have lost magnetism by im- 

 parting it to their patients, but by the too firm compression of the 

 patient's tissues they are not allowed to glide over each other ; and 

 hence such a way of proceeding entirely fails of the object for which 

 it is intended. Surely, cultivation is the economy of effort. 



Friction and manipulation can be used alternately, varied with 

 rapid pinching of the skin and deeper grasping of the subcutaneous 

 cellular tissue and muscular masses, and, when necessary, with per- 

 cussion, passive, assistive, and resistive movements, finishing one con- 

 venient surface or limb before passing to another, and occupying from 

 half an hour to an hour with all or part of these procedures. Pinching 

 is used mainly to excite the circulation and innervation of the skin, and 

 for this purpose it is best done rapidly at the rate of one hundred to one 

 hundred and twenty-five per minute with each hand. To act on the 

 subcutaneous cellular tissue, a handful of skin is grasped and rolled 

 and stretched more slowly than by the preceding method. A deeper, 

 momentary grasping of the muscles is often advantageous, and may 

 be called a mobile intermittent compression, and this, indeed, is what 

 the whole of massage, strictly speaking, consists of. Percussion, ap- 

 plicable only over muscular masses, may be done in various ways. In 

 the relative order of their importance they are as follows : 1. With 

 the ulnar borders of the hands and fingers. 2. The same as the first, 

 with the fingers separated. 3. With the ends of the fingers, the tips 

 being united on the same plane. 4. With the dorsum of the upper 

 halves of the fingers loosely flexed. 5. With the palms of the hands. 

 6. With the ulnar borders of the hands tigrhtlv shut. 7. With the 

 palms of the hands held in a concave manner, so as to compress the 

 air while percussing. More gentle or vigorous and rapid percussion 

 than any of these methods afford can be done by securing India-rubber 

 air-balls on whale-bone or steel handles. With these one gets the 

 spring of the handles together with the rebound of the balls, and thus 

 rapidity of motion with easily varying intensity is gained, the num- 

 ber of blows varying from two hundred and fifty to six hundred a 

 minute with both. 



Remedial movements have been so well described in books on the 

 so-called " movement-cure " that little need be said of them here. It is 

 well for those who use them to know the anatomy and physiology of the 

 joints and their natural limits of motion. Except in the case of relaxed 

 joints, passive motion should be pushed until there is a feeling of 

 slight resistance to both patient and manipulator ; for by this will be 

 known that in healthy joints the ligaments, capsules, and attachments 

 of the muscles are being acted upon. Resistive movements are such 

 as the patient can make while the operator resists. The opposing 



