I have said above that the face was not touched in the course of the rubbing. There are cases, however, in which ma.s.sage of the head and face may be usefully practised. Some obstinate neuralgias are helped by it temporarily, and very often it is of use with other means to aid in a permanent cure. Many headaches of a pa.s.sing character may be dissipated promptly by careful ma.s.sage of the head or by downward stroking over the jugular veins at the sides of the neck to lessen the flow of blood into the cerebral vessels, where the pain is due to congestion or distention, and careful manipulation of the facial muscles in paralysis is of service in restoring loss of tone and improving their nutrition. It is worth adding here, as women patients frequently say that during their illness the hair has become thin or shown a great tendency to fall, that daily firm finger-tip ma.s.sage of the head for ten or twelve minutes, followed by rubbing into the scalp of a small amount of a tonic, either a bland oil or if need be of some more stimulating material, will in a great majority of the instances where loss of hair is due to general ill-health perfectly restore its vigor and even its color.

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 ma.s.sage. 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 ma.s.sage 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 ma.s.sage and not having a pract.i.tioner 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 ma.s.sage 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.

CHAPTER VII.

ELECTRICITY.

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.[24] 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 a.s.sistant 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.[25]

No such obvious and visible results are seen as we observe after ma.s.sage, but the thermal changes are much more constant and remarkable, and show at least that we are not dealing with an agent which merely amuses the patient or acts alone through some mysterious influence on the mental status.

A half-hour's treatment of the muscles commonly gives rise to a marked elevation of temperature, which fades away within an hour or two. This effect is, like that from ma.s.sage, most notable in persons liable to fever from some organic trouble, and it varies as to its degree in individuals who have no such disease.

The first case, Miss B., aet. 20, is an example of tubercular disease of the apex of the right lung. She had a morning temperature of 98-1/2 to 99-1/2, and an evening temperature of 100 to 102.

Electricity was used about 11 o'clock daily, with these results:

Before Electricity. After Electricity.

November 25 99 99-3/5 " 27 97-3/5 100 " 28 98 99 " 29 98-4/5 99-4/5

December 2 100-1/5 101-3/5 " 4 99-1/5 100-1/5 " 5 99-2/5 99-1/5

Mrs. R., aet. 40, the next case, was merely a rather anaemic, feeble, and thin woman, who for years had not been able to endure any prolonged effort. She got well under the general treatment, gaining thirteen pounds on a weight of ninety-eight pounds, her height being five feet and one inch. The facts as to rise of temperature are most remarkable, and, I need not say, were carefully observed.

Temperature taken in the mouth while at rest in bed.

Before Electricity. After Electricity.

April 2 98-2/5 98-4/5 " 3 98-1/5 98-2/5 " 4 98-1/5 98-2/5 " 5 98 98-3/5 " 6 97-9/10 98-7/10 " 7 98 98-5/10 " 8 98 98-3/5 " 9 98 98-1/10 " 10 98-2/5 98-3/5 " 11 98-5/10 98-7/10 " 12 98-3/5 99-1/10 " 13 98-1/5 99-5/10 " 14 98-2/5 99-1/5 " 16 98-4/10 99-1/10 " 17 98-5/10 99-2/10 " 18 98-7/10 99-1/10 One hour later, 99-1/10 " 19 98-9/10 99-3/10 " " " , 98-4/5

Before Electricity. After Electricity.

April 20 99 99-1/10

" 21 98-9/10 99-2/10 Menstrual period.

" 30 98-3/5 98-3/5

May 1 98 98-5/10

" 2 98 98-3/10

The third case, Miss M., aet. 33, was that of a pallid woman, the daughter of a well-known physician in the South. She suffered for six years with "nervous exhaustion," headaches, pain in the back, intense depression of spirits, nausea, and repeated attacks of hysteria. She slept only under anodynes, and used stimulants freely. Under the use of rest and the adjuvant treatment described, Miss M. made a thorough recovery, and was restored to useful active life.

Miss M. Thermometer held in mouth.

Before Electricity. After Electricity.

May 14 99-1/10 99-1/10 } Menstruating; general } faradization only.

" 15 99 99-1/5 }

" 16 99-1/5 99-1/5 Gen'l faradization and limbs.

" 17 98-4/5 99-1/5

" 18 98-4/5 99-1/5

" 19 98-1/5 98-4/5

" 21 98-3/5 99

" 22 98-4/5 99-1/10

Before Electricity. After Electricity.

May 25 98-1/10 98-4/10

" 26 98-1/10 99-1/10

" 29 98-3/5 99

" 30 98-5/10 99-1/10

" 31 98-9/10 99-1/10

Mrs. P., aet. 38, was a rather nervous woman, easily tired, but not anaemic and not very thin. She improved greatly under the treatment.

Before Electricity. After Electricity.

January 27 98-3/5 99-1/5 Thermometer in axilla ten

" 29 98-2/5 99-1/5 minutes before and after.

" 30 99-1/5 99-3/5

" 31 98-4/5 99-2/5

February 1 99 99-2/5 Menstrual period.