taken
in time massage is really a specific in the treatment of hemorrhoids.
This is mentioned only to emphasize the importance \
of the introductory massage in all manual
treatment. The success of massage used in joint affections will often de\
pend upon how well and how
judiciously the introductory treatment is applied.
GENERAL MASSAGE
By general massage we mean the treatment applied to\
the whole body, with the exception of the
head.
The operator begins with the foot, stroking with on\
e hand or kneading with the thumbs. Then he
proceeds with the legs, the arms, the chest, the abdomen, and finally th\
e back. All the manipulations may
be used, and special attention should be
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given to the hacking. Some authors advise to first take the extremities,\
then the back, and finally the neck
and abdomen (Kleen and others). With this treatment we generally combi\
ne a few passive rotations or
flexions, similar to those recommended for anemia. The patient must be l\
ying in bed, well covered on
those parts not operated upon. It is of advantage for the operator to be\
gin with the left foot and leg, and
then have the patient turn over to the other side of the bed, where the \
balance of the treatment may be
conveniently performed.
In regard to the time necessary to spend in giving \
general massage, I would advise the operator to
begin with thirty minutes, and gradually increase the time so that one h\
our is consumed at the end of the
first week. The length and the severity of the treatment should always b\
e regulated by the patient's
condition. General massage should not be employed until two hours have e\
lapsed after meals; As soon as
a part is operated upon it should be covered up at once.
LOCAL MASSAGE
By local massage we mean the treatment applied to the different parts of the bod\
y at one time; for
instance, massage of the shoulder.
I. MASSAGE OF THE LEG
l Position . -- The patient is lying or half lying on a bed or couch. The operator \
sitting at his side
performs the following manipulations:
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l 1. Stroking of the foot sole and dorsum; quick stroking with the palm of\
the hand to the sole of the
foot finishing with firm and quick clappings with one hand, the other gr\
asping the ankle underneath, so
as to elevate the limb.
l 2. Stroking with both hands from the ankle to the hip, the hand on the o\
utside reaching up to the crest
of the ilium, the thumb of the hand on the inside, with moderate pressur\
e, going down toward the groin.
(Avoid pressure upon the tibia.)
l 3. Friction with the thumb upon the outside of the leg from ankle to kne\
e-joint, covering principally
the flexors of the foot.
l 4. Stroking with one hand of the same part.
l 5. Friction with the thumb upon the inside and posterior part of the leg\
, covering principally the
gastrocnemius and the soleus.
l 6. Stroking with one hand of the same part.
l 7. Friction with the thumb or hand upon the outside, inside and the back\
part of the thigh, dividing it
into four distinct parts so as to thoroughly work upon all the different\
muscles.
l 8. Repeated strokings over the whole extremity, from ankle to hip.
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l 9. Kneading with the two thumbs or both hands upon the different muscles\
of the whole extremity.
l 10. Hacking or clapping upon the whole extremity, avoiding the bones.
In certain cases (dropsy, rheumatism, etc.),
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it is well to have the limb elevated, thereby promoting the return of th\
e venous blood.
The limb should be frequently turned, so that the p\
osterior part may receive proper attention.
II. MASSAGE OF THE ARM
l Position . -- The patient is sitting or lying, with the semiflexed arm supported,\
if convenient. The
operator sits at the side.
l 1. Stroking with one hand on the outside of the arm, from the wrist to t\
he trapezius. The other hand
should support around the wrist, but care should be taken that no pressu\
re be used over the radial artery,
as that checks circulation considerably.
l 2. Stroking with the other hand upon the inside of the arm, from wrist t\
o shoulder-joint, the thumb
going out toward the pectoral muscles. Support is given in a similar man\
ner as described in 1.
l 3. Friction with the thumb upon the extensors of the hand and fingers wi\
th repeated strokings of the
same part.
l 4. Friction with the thumb of the other hand upon the flexors of the han\
d and fingers, with repeated
strokings upon the same part.
l 5. Friction with the hand upon the
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