manipulation, but also that of their patients, giving to the latter a motion and sensation as if they were at sea in stormy weather. By this display of awkward and unnecessary energy, not only do they soon tire themselves, and say that they have lost magnetism by imparting it to their patients, but by the too firm compression of the patient's tissues they are not allowed to glide over each other; and hence such a way of proceeding entirely fails of the object for which it is intended. Surely, cultivation is the economy of effort.
Friction and manipulation can be used alternately, varied with rapid pinching of the skin and deeper grasping of the subcutaneous cellular tissue and muscular masses, and, when necessary, with percussion, passive, assistive, and resistive movements, finishing one convenient surface or limb before passing to another, and occupying from half an hour to an hour with all or part of these procedures. Pinching is used mainly to excite the circulation and innervation of the skin, and for this purpose it is best done rapidly at the rate of one hundred to one hundred and twenty-five per minute with each hand. To act on the subcutaneous cellular tissue, a handful of skin is grasped and rolled and stretched more slowly than by the preceding method. A deeper, momentary grasping of the muscles is often advantageous, and may be called a mobile intermittent compression, and this, indeed, is what the whole of massage, strictly speaking, consists of. Percussion, applicable only over muscular masses, may be done in various ways. In the relative order of their importance they are as follows: 1. With the ulnar borders of the hands and fingers. 2. The same as the first, with the fingers separated. 3. With the ends of the fingers, the tips being united on the same plane. 4. With the dorsum of the upper halves of the fingers loosely flexed. 5. With the palms of the hands. 6. With the ulnar borders of the hands tightly shut. 7. With the palms of the hands held in a concave manner, so as to compress the air while percussing. More gentle or vigorous and rapid percussion than any of these methods afford can be done by securing India-rubber air-balls on whale-bone or steel handles. With these one gets the spring of the handles together with the rebound of the balls, and thus rapidity of motion with easily varying intensity is gained, the number of blows varying from two hundred and fifty to six hundred a minute with both.
Remedial movements have been so well described in books on the so-called "movement-cure" that little need be said of them here. It is well for those who use them to know the anatomy and physiology of the joints and their natural limits of motion. Except in the case of relaxed joints, passive motion should be pushed until there is a feeling of slight resistance to both patient and manipulator; for by this will be known that in healthy joints the ligaments, capsules, and attachments of the muscles are being acted upon. Resistive movements are such as the patient can make while the operator resists. The opposing
