(see Fig. 113).
FIG. 8. -- Kneading on the Hand for Contracted Tendons and Muscles.
FRICTION WITH THE TIPS OF THE FINGERS is used aroun\
d the joints, the thumb often
supporting the hand (see Fig. 6). The circles are sometimes made a gre\
at deal smaller than demonstrated
in Fig. 6.
FRICTION WITH THE ONE HAND is used upon the larger \
surfaces and fleshier parts, like the
thigh, arm proper, and lumbar region of back.
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All FRICTIONS should be centripetal, and should always be followed by centripetal strokings, as the
aim of this manipulation is to transform pathologically changed parts in\
to a condition that will
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FIG. 9. -- Kneading (Pétrissage) of Biceps.
permit them to be incorporated into the healthy tissues, and thence be a\
bsorbed by the veins and
lymphatics.
3. PÉTRISSAGE (KNEADING)
This manipulation is performed in such a manner as \
to cause a double centripetal pressure on a tissue
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(muscle or tendon), at the same time raising it up from its normal poi\
nt of attachment.
We have three different kinds of Pétrissage:
l (a ) Kneading with the two thumbs.
l (b ) Kneading with the thumb and fingers.
FIG. 10. -- Kneading with Both Hands.
l (c ) Kneading with the two hands.
KNEADING WITH THE TWO THUMBS (see Figs. 7 and 8) \
is used to reach individual muscles.
KNEADING WITH THE THUMB AND FINGERS, which manipula\
tion is called PINCHING (see
Fig.
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9), is also used to reach individual muscles, but is preferred on a dee\
p-seated tissue.
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FIG. 11. -- Clapping of the Leg.
FIG. 12. -- Position of Hands in Hacking.
KNEADING WITH BOTH HANDS, called SQUEEZING, is used\
upon the lower extremities, and
upon the arm proper (see Fig. 10) of adults.
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The aim of the manipulation KNEADING is to reach the separate muscles with a firm double
pressure and expose them to an action similar to that of FRICTION.
4. TAPOTEMENT (PERCUSSION)
This manipulation is always performed by the operator's wrist, the hands\
striking quickly .
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FIG. 13. -- Position of Hands in Punctation of the Forehead.
We have four different kinds of Percussion:
l (a) CLAPPING (see Fig. 11) is performed with the palms of the hands. It\
is used to act upon the
skin and the superficial nerves and vessels.
In clapping it is advisable to spread a towel over \
the skin to avoid stinging. -- ( Editor).
l (b ) HACKING (see Fig. 12) is performed with
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the ulnar border of the hand. It is used around nerve centers and upon t\
he muscles.
l ( c ) PUNCTATION (see Fig. 13) is performed with the tips of the fingers.\
It is used upon the head and
in circles around the heart.
FIG. 14. -- Beating over the Sciatic Nerve.
l ( d ) BEATING (see Fig. 14) is performed by the clenched hand. It is used\
upon the glutei and upon the
lower extremities over the sciatic nerve.
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MASSAGE AS A THERAPEUTIC AGENT
is divided into Introductory, General and Local.
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INTRODUCTORY MASSAGE
In many affections it is necessary to commence the \
operation of massage with what has been termed
introductory treatment.
In the majority of cases of both acute and chronic \
affections of the joints it is well to apply the
treatment to the neighborhood of the part, and especially above it. This\
is essential if the skin is abraded
or if a severe inflammation of the part exists rendering it sensitive to\
too much pain from pressure.
The treatment consists of centripetal strokings (w\
ith one or both hands) in connection with a few
kneadings.
Special attention should be paid to the inside part\
s of the extremities where the principal veins and
lymphatics pass. If possible and convenient, always try to get the aid o\
f gravity by elevation.
By this treatment we prepare the venous and lymphat\
ic systems to absorb the diseased particles
subsequently expelled from the affected part.
If for instance we have a case of synovitis of the
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knee-joint we commence by stroking the inside part of the thigh, slightl\
y elevating the lower part of the
extremity so as to get the aid of gravity. The introductory massage in t\
reating circulatory and nervous
affections of the head consists of Hoeffinger's method of massage of the\
neck so as to procure a free
outlet for the venous blood from the head.
In the treatment of hemorrhoids by massage we shoul\
d always commence by treating the liver,
thereby procuring an outlet for the congested blood of the abdomen throu\
gh the portal vein. When
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