territory, while the anterior and lateral aspects will be another for thorough and efficacious friction. The same systematic division of surface may be made above the knees as below, the number of strokes below will vary from one hundred to one hundred and sixty with each hand; above, from seventy-five to one hundred each. From the base of the skull to the spine of the scapula forms another region naturally well bounded for downward and outward semicircular friction, and from the spine of the scapula to the base of the sacrum and crest of the ilium forms another surface over which one hand can sweep, while the other works toward it from the insertion to the origin of the glutei, at an average rate of sixty or seventy-five a minute with each hand for a person of medium size. It will be observed that on the back and thighs the strokes are not so rapid as on the other parts mentioned, for the reason that the skin is here thicker and coarser, in consequence of which the hand can not glide so easily, and the larger muscles beneath can well bear stronger pressure; besides, the strokes are somewhat longer, all of which require an increased expenditure of time. The chest should be done from the insertion to the origin of the pectoral muscles, and the abdomen from the right iliac fossa in the direction of the ascending, transverse and descending colon. But here friction is seldom necessary, for the procedure about to be considered accomplishes all that friction can do, and a great deal more in this region. The force used in doing friction is often much greater than is necessary, for it is only intended to act upon the skin, and there are better ways of acting upon the tissues beneath it. If redness and irritation be looked upon as a measure of the beneficial effects of friction upon the skin, then a coarse towel, a hair mitten, or a brush would answer for this purpose a great deal better than the hand alone.
The most important, agreeable, and efficacious procedure of massage has been variously designated as manipulation, kneading, deep rubbing, or massage properly so called, in contradistinction to the more superficial method spoken of above. This is done by adapting as much as possible of the fingers and hands to the parts to be thus treated, and, without allowing them to slip on the skin, the tissues beneath are kneaded, rolled, and manipulated in a circulatory manner, proceeding from the insertion toward the origin of the muscles, from the extremities to the trunk, in the direction of the returning blood and lymphatic currents. For this purpose the same divisions of surface as for friction will be found most convenient. Beginning then with the fingers from the roots of the nails, the thumb of the manipulator will be placed on one of the fingers of the patient, and parallel to the latter, while on the opposite side the index-finger will be placed at right angles to this, and between the two the finger of the patient will be compressed and malaxated, in a rotary manner, at the rate of seventy-five to one hundred and fifty per minute. The dorsal and palmar surfaces will of course receive special attention, while the
