REMEDIAL MEASURES AND REMEDIAL METHODS. 137 



causes, the muscular structure itself suffers and the peripheral 

 circulation becomes very feeble. Much of the albuminous liquid 

 which escapes from the blood vessels and diffuses itself through 

 the tissues, after serving the purpose of nutrition, is taken up 

 by the lymphatics and returned to the great blood vessels. If 

 there be any driving of this liquid from the periphery to the 

 center it is so feeble that the return of the juices depends chiefly 

 upon the squeezing of the various juice channels during muscu- 

 lar contraction. During habitual inactivity, the movement of 

 fluids in the juice channels outside of the blood vessels is ex- 

 cessively sluggish, and it is one great object of the stroking 

 movements in massage to force these juices onward. General 

 stroking movements, if properly administered, are very quieting 

 to the patient, removing nervousness and even pain. 



The kneading and percussion movements of massage act 

 chiefly upon the local circulation. Both these ^^I'ocesses have a 

 distinct effect upon the capillary circulation. Where the fibers 

 of the muscles within their sheaths become agglutinated, and the 

 skin itself becomes abnormally tense and attached to the sub- 

 dermic tissue, as a result of rheumatic muscular affection and 

 bad condition of the system generally, kneading has the power 

 to remove this condition by mechanically loosening the aggluti- 

 nated fibers and by so stimulating the local circulation as to 

 cause absorption of exudations. This condition is generally 

 known as hide-bound. 



The first seance in general massage should not last longer than 

 from twenty minutes to a half hour, but in a little time a full 

 hour will be required. When there is lack of digestive power, 

 constipation, or similar symptoms — the outcome of sluggishness 

 of the abdominal circulation and nerve supply — local massage 

 of the abdominal and pelvic region should be freely employed. 

 In the treatment of sprains local massage is beneficial after the 

 first stages of inflammation and irritation have passed. In mus- 

 cular rheumatism or chronic inflammation of the joints, it is of 

 great value. In various forms of paralysis local massage is of 



