L36 MASSAGE. 



5. Active and passive movements. 



To prevent formation of pustules at the roots of the hair, which 

 would put a stop to further massage, it is usual in human practice 

 to shave the affected spot and coat the parts with some lubricant, 

 but this is not absolutely needful. According to the effect produced 

 massage is applied for periods extending to an hour or more daily, 

 provided, of course, that the reaction in the affected parts permits 

 of it. At first massage generally causes pain, which, however, dis- 

 appears on each occasion during the process, and is replaced by a 

 pleasant feeling of warmth, flexibility, and increased power in the 

 parts. 



From the above it will be seen that massage favours increase of 

 bodily strength and endurance, but its best effects can only be 

 obtained by practice and by a thorough knowledge of the patho- 

 logical processes to be combated, the exact anatomy of the diseased 

 parts, and the physiological effects of the different massage manipu- 

 lations. Experiment shows that the effects vary, similar manipu- 

 lations being irritant or soothing, inclined to produce or to dissipate 

 congestion, and to alleviate or arouse pai •, according to the idio- 

 syncrasy of the patient. The operator must first clearly conceive 

 the changes he desires to effect in the diseased parts, as only then 

 can he reasonably expect to effect improvement, or even to know 

 whether massage is likely to be of benefit apart from choosing the 

 exact system to be followed in the case in question. 



The action of massage depends on its favouring and increasing 

 absorption, accelerating circulation, and relieving pain. By stroking 

 centripetally, not only is circulation in the collecting vessels locally 

 stimulated and tension relieved, but mechanical congestion in parts 

 removed from the centre is lessened and exuded lymph absorbed, 

 while extravasations in the tissues themselves are distributed over 

 a larger area, are brought in contact with numerous absorbents, 

 and are mechanically assisted in entering them. For these reasons 

 it is best to commence not at the diseased spot itself but on the 

 central side of it, and gradually to approach the diseased spot in 

 order to first clear a space, into which the exudate or extravasation 

 may more readily flow. 



Mosengeil's experiments prove it possible to remove fluid even 

 from joints by pressure and stroking. He injected Indian ink into 

 the synovial cavities of rabbits, and in two or three minutes reduced 

 the joints to their normal form by massage. On post-mortem 

 examination the Indian ink was found in the nearest lymphatic 

 channels, vessels, and glands. 



