73 o THE POPULAR SCIENCE MONTHLY. 



force should be carefully and instinctively kept within the limits of 

 the patient's strength, and this, with all these other manoeuvres, should 

 stop short of fatigue. To alternately resist flexion and extension is 

 the pons asinorum of manipulators, and, in a considerable experience 

 of teaching massage, I have found but few who could learn to do it 

 at all. Its importance can not be overestimated as a means of culti- 

 vating the strength of weakened muscles, while, at the same time, 

 finding out how much they can be used. Many a patient who has 

 recovered from an old injury is still as much incapacitated as ever, 

 from the fact that his latent energies can only be discovered and 

 made available in this manner. Midway between passive and resistive 

 movements, in the course of certain recoveries, stand assistive move- 

 ments. They are but little understood and seldom used. They may 

 be illustrated as follows : Let it be supposed that, in the absence of 

 adhesions and irreparable injury of the nerve-centers, the deltoid has 

 but half the strength requisite to elevate the arm. So far as any use 

 is concerned this is the same as if there were no power of contraction 

 left in the muscle. But, if only the other half of the impaired vigor 

 be supplemented by the carefully graduated assistance of the operator, 

 the required movement will take place ; and, in some cases, if this be 

 regularly persisted in, together with manipulation and percussion, 

 more vigorous contraction will be gained, and, by-and-by, the patient 

 will exert three fourths of the necessary strength, and later the whole 

 movement will be done without aid ; and, as strength increases, re- 

 sistance can be opposed to the movement. Partial loss of motion can 

 often be accurately estimated by holding the limb suspended in a 

 cloth attached to a spring-balance. When the patient makes effort 

 the limb weighs less. By means of a spring-balance resistive motion 

 can also be estimated. Still another kind of movement may be spoken 

 of namely, vigorous passive motion with a view to breaking up ad- 

 hesions in and about joints, a description of which does not come with- 

 in the scope of this paper. It is the secret of success and of failure of 

 the people who call themselves " bone-setters," the methods of whom 

 have been well studied and explained by Dr. Wharton P. Hood, of 

 London, in his very interesting book " On Bone-Setting, so called." 



A description of massage of the head and the benefits that arise 

 from it must be left to another time. 



The relative importance of the foregoing procedures has been 

 partly indicated while describing them. According to the needs of 

 individual cases, one or more of these will predominate or be omitted, 

 and it is well that the advice of a physician be sought on this subject, 

 for there would be no use in giving a patient friction the capillary cir- 

 culation of whose skin was already sufficiently good ; and it would be 

 a waste of time and strength to administer passive and resistive move- 

 ments to patients who were already fatigued from overwork. To rouse 

 the dormant action of cold skin and flabby muscle, percussion will be 



