I am accustomed to pay a good deal of attention to the observations made on these and other points by practised manipulators, and I find that their daily familiarity with every detail of the color, warmth, and firmness of the tissues is of great use to me.
A great deal of nonsense is talked and written as to the use and the usefulness of massage. The “professional rubber” not unnaturally makes a mystery of it, and patients talk foolishly about “magnetism” and “electricity;” but what is needed is a strong, warm, soft hand, directed by ordinary intelligence and instructed by practice; and this is the whole of the matter, except in the massage of such obscure conditions as need full knowledge of the anatomical relations and physiological functions of the parts to be rubbed. It is a fact that I have known country physicians who, desiring to use massage and not having a practitioner of it within reach, have themselves trained persons to do it, with considerable resultant success.
It is not, perhaps, putting it too strongly to say that bad massage is better than none in those cases in which manipulation is needed. Very little harm can result from its use even by unskilled hands, provided that reasonable intelligence direct them.
Electricity is the second means which I have made use of for the purpose of exercising muscles in persons at rest. It has also an additional value, of which I shall presently speak.
In order to exercise the muscles best and with the least amount of pain and annoyance, we make use of an induction current, with interruptions as slow as one in every two to five seconds, a rate readily obtained in properly-constructed batteries. This plan is sure to give painless exercise, but it is less rapid and less complete as to the quality of the exercise caused than the movements evolved by very rapid interruptions. These, in the hands of a clever operator who knows his anatomy well, are therefore, on the whole, more satisfactory, but they require some experience to manage them so as not to shock and disgust the patient by inflicting needless pain. The poles, covered with absorbent cotton well wetted with salt water, which may be readily changed, so as not to use the same material more than once, are placed on each muscle in turn, and kept about four inches apart. They are moved fast enough to allow of the muscles being well contracted, which is easily managed, and with sufficient speed, if the assistant be thoroughly acquainted with the points of Ziemssen. The smaller electrode should cover the motor-point and the larger be used upon an indifferent area. After the legs are treated, the muscles of the belly and back and loins are gone over systematically, and finally those of the chest and arms. The face and neck are neglected. About forty minutes to an hour are needed; but at first a less time is employed. The general result is to exercise in turn all the external muscles.