As I have said already, there are persons who, under circumstances seemingly alike, have from massage a large rise of temperature, and others who experience none.  I give a single case of what is rare but not exceptional,—­an almost constant fall of temperature.

Miss N., aet. 21, hysteria, good condition: 

Before Massage.  After Massage.

     98 97-3/5

     98-1/2 98-1/2

     98 98

     98-2/5 98

     98-4/5 98

These facts are, of course, extremely interesting; but it is well to add that the success of the treatment is not indicated in any constant way by the thermal changes, which are neither so steady nor so remarkable as those caused by electricity.

If now we ask ourselves why massage does good in cases of absolute rest, the answer—­at least a partial answer—­is not difficult.  The secretions of the skin are stimulated by the treatment of that tissue, and it is visibly flushed, as it ought to be, from time to time, by ordinary active exercise.  Under massage the flabby muscles acquire a certain firmness, which at first lasts only for a few minutes, but which after a time is more enduring and ends by becoming permanent.  The firm grasp of the manipulator’s hand stimulates the muscle, and, if sudden, may cause it to contract sensibly, which, however, is not usually desirable or agreeable.  The muscles are by these means exercised without the use of volitional exertion or the aid of the nervous centres, and at the same time the alternate grasp and relaxation of the manipulator’s hands squeezes out the blood and allows it to flow back anew, thus healthfully exciting the vessels and increasing mechanically the flow of blood to the tissues which they feed.  It is possible also that a real increase in the production of red corpuscles is brought about by repeated applications of massage, as will be seen later on.

The visible results as regards the surface-circulation are sufficiently obvious, and most remarkably so in persons who, besides being anaemic and thin, have been long unused to exercise.  After a few treatments the nails become pink, the veins show where before none were to be seen, the larger vessels grow fuller, and the whole tint of the body changes for the better.

In like manner the sore places which previously existed, or which were brought into sensitive prominence by the manipulation, by degrees cease to be felt, and a general sensation of comfort and ease follows the later treatments.

Although this plan of acting on the muscles seems to dispense with any demands upon the centres, it is not to be supposed that it is altogether without influence on these parts.  In fact, extreme use of massage occasionally flushes the face and causes sense of fulness in the head or ache in the back.  The actual large increase in the number of corpuscles in the circulation brought about by massage may be one of the reasons for this.  We have added, perhaps, millions of cells to the number in the vessels in a very short time, and need not be astonished if some signs of plethora follow.  Moreover, in some spinal maladies it has effects not to be altogether explained by its mechanical stimulation of the muscles, nerves, and skin.