MASSAGE, a method of treating stiffness or other physical conditions by manipulating the muscles and joints, practised from time immemorial in all parts of the world and employed extensively for medical purposes at the present time.
Massage, as now practised, includes several processes, some passive, others active. The former are carried out by an operator, and consist of rubbing and kneading the skin and deeper tissues with the hands and exercising the joints by bending the patient's limbs. The active movements consist of a special form of gym nastics, designed to exercise particular muscles or groups of muscles. In "Swedish massage" the operator moves the limbs while the patient resists, thus bringing the opposing muscles into play. Sometimes the word "massage" is restricted to the rub bing processes, "manipulation" being used to cover all the move ments mentioned.
Rubbing has been subdivided into several processes, namely (I) stroking, (2) kneading, (3) rubbing and (4) tapping, and great importance is attached to the application of a particular process in a particular way. Oils and other lubricants may or may not be used. But, however applied, the treatment acts essentially by increasing circulation and improving nutrition. It was shown by Lauder Brunton that more blood actually flows through the tissues during and after rubbing. The number of red corpuscles, and, to some extent, their haemoglobin value, are said to be increased (Mitchell). At the same time the move ment of the lymph stream is accelerated. In order to assist the flow of blood and lymph, stroking is applied centripetally, i.e., upwards along the limbs and the lower part of the body, down wards from the head. The effects of the increased physiological activity set up are numerous. Functional ability is restored to exhausted muscles by the removal of fatigue products and the induction of a fresh blood supply; congestion is relieved; col lections of serous fluid are dispersed; secretion and excretion are stimulated; local and general nutrition are improved. These effects indicate the conditions in which massage may be use fully applied. Such are various forms of paralysis and muscular wasting, chronic and subacute affections of the joints, muscular rheumatism, sciatica and other neuralgias, local venous con gestions, convalescent fractures of bones, sprains, contractions, obesity and chronic constipation. In certain other conditions
massage gives relief, probably in large measure by suggestion (q.v.). Such are insomnia, some forms of headache, hysteria and neurasthenia, disorders of the female organs, melancholia and other forms of insanity and morphinism.
The therapeutic value of massage when judiciously used is undoubted, but it is not appropriate for fevers, pregnancy, col lections of pus, acute inflammation of the joints, inflamed veins, fragile arteries, wounds of the skin, and generally speaking, those conditions in which it is not desirable to increase the circula tion, or the patient cannot bear handling.
Massage of the face and neck forms the basis of most systems of modern beauty culture. By stimulating circulation and the flow of lymph, by clearing the tissues of accumulated wastes and increasing their nutrition, massage has the effect of clearing and refining the skin and making the contours of the face and neck smooth and firm.
The revival of massage in Europe and America has called into existence a considerable number of professional operators, both male and female, who may be regarded as forming a branch of the nursing profession. Several things are required for a good operator. One is physical strength. Deep massage is very la borious work and cannot be carried on for even half an hour without unusual muscular power. A second important require ment is tactile and muscular sensibility. A person not endowed with a fine sense of touch and resistance is liable to exert too great or too little pressure; the one hurts the patient, the other is ineffective. Then skill and knowledge, which can only be ac quired by a course of instruction, are necessary. Finally, the standard of personal character necessary is that required for the nursing profession in general. Massage should always be carried out under medical direction and in proper surroundings.