MASSAGE 277 



The action appears to be not exclusively mechanical but partly 

 djniamic. The most important local effects of massage are a 

 cleansing, stimulant, anodyne and a dynamic action. In addi- 

 tion, massage produces important general effects. Its influence 

 upon the individual organs is as follows: 



1. The circulation of the blood and lymph is influenced by 

 massage first of all. The action here is the same as that which 

 occurs during motion in the vessels of the extremities, where the 

 venous blood and lymph is forced centripetally toward the heart 

 by the contraction of the muscles and the tension of the fascia 

 with the cooperation of the valves of the vessels, a process which 

 may be called a natural or physiological massage. The pressure 

 exerted upon the body by artificial massage produces at first an 

 anaemia of the parts concerned m consequence of the blood and 

 lymph being pressed out of the veins and Ijrmph vessels toward 

 the heart. With the cessation of the pressure, a large amount of 

 fresh blood flows into the empty spaces and the area becomes 

 hyperaemic (aspiratory and pressure action). The repeated alter- 

 nate occurrence of anaemia and hyperaemia stimulates and acceler- 

 ates the circulation in the massaged parts. 



2. The acceleration of the circulation brings about an increase 

 of metabolism, leucocjrtosis, histolysis, and local antitoxin forma- 

 tion, promotes retrogressive changes and regeneration, stimulates 

 the resorption of the products of fatigue and metabolism, patho- 

 logical products, exudates and extravasations, and improves the 

 nutrition of the part massaged (experiments of Mosengeil with 

 pigments injected into the joints). 



3. Solid, fibrinous exudates and blood coagula beneath the 

 skin, in tendon sheaths and in joint cavities are mechanically 

 crushed by massage and thus prepared for resorption. In addi- 

 tion, swellings of the skin and mucous membranes, subcutis, 

 musculature, tendons and tendon sheaths, joints, etc., are reduced 

 in volume. 



4. Contractions of the musculature are overcome by tapping 

 the muscle; simple rubbing and stroking brings about hyperaemia 



