The Art of Massage
J. H. Kellogg, M.D.
RULES RELATING TO MASSAGE.
1. Correct Use of Terms. - In speaking of
massage or its application, be careful to use correct terms (pp. 238, 239).
2. Good Health Necessary. - Of all persons,
one who administers massage should have perfect health. The so-called magnetism
which renders some persons so much more successful than others in massage,
as well as in other callings, is largely the outgrowth of the vivacity,
freshness, good cheer and good nature which result from abounding health.
A few things of special importance in this relation are proper diet; healthful,
loose, and appropriate clothing; a daily cool morning sponge bath; and
daily out-of-door exercise.
3. Personal Cleanliness. - Massage is hard work,
equal to almost any form of manual labor. A masseur who does his duty will
perspire vigorously; hence the necessity of due attention to personal cleanliness.
Cleansing of the skin may be promoted by the addition of a little carbonate
of ammonia to the water used for the morning bath. When one perspired freely,
stockings and underclothing should be changed daily. After airing for a
day or two, the same garment may be worn again for a day. Special attention
must also be given to the hands, teeth, and also the nasal cavity, if a
catarrhal condition is present, and to the hair and scalp.
4. The Hands. - Good hands are necessary
for success in massage. The hands must be soft, warm, dry, strong, and
elastic. A bony, sweaty, hard, or calloused hand is exceedingly objectionable.
The hands should also be free from blemishes, such as warts, abrasions,
chaps, etc. The nails should be trimmed close. Absolute cleanliness, is
the best means of promoting a healthy state of the skin of the hands, as
well as, other parts. A perfectly clean hand is not likely to chap. Always
wash the hands just before giving massage; doing so, if convenient, in
the presence of the patient, or at least with his knowledge. Always wash
the hands a second time just before manipulating the head, face, or neck,
if the hands have been used upon other parts since washing. The following
lotions are valuable for keeping the hands in a healthy state:-
(1) Comp. tri benzoin ..............................
(2) Borax .................................................dr.
Carbonate of soda ...............................dr.
Carbonate of ammonia .........................dr.
Aquae ammonia, ..................................dr.
Water to make ....................................
5. The Personal Appearance. -Simplicity, neatness,
and tidiness in dress are in the highest degree commendable. The personal appearance
should be made attractive by extreme care and appropriateness in dress, without
showiness, which always indicates vulgarity or ignorance. Nurses connected with
a hospital in which a uniform is used should always wear it when on professional
6. No person should undertake to practice massage who has
not received a thorough practical training. Massage is both an art and a science,
and only those who have had long practice can be thoroughly efficient.
7. Never countenance the belief that vitality, magnetism
or any other occult force is imparted by manipulation. Avoid flourishes.
8. Do not be hurried, flurried, nor out of breath from fast
walking, in approaching a patient to administer massage.
9. Avoid a bustling, nervous manner.
10. Only in most extraordinary cases and under exceptionally
justifying circumstances, and, then only in the presence of other persons, should
a masseur or a masseuse administer massage to an adult person of the opposite
11. The room in which massage is given should be well ventilated,
temperature about 75o to 80o F.
12. As a rule, the patient should be undressed, or clad in
.a single loose gown. Care should be taken to keep the body well covered, with
the exception of the part undergoing manipulation.
13. The patient should be placed in an easy, comfortable
14. The position of the operator varies with the part operated
upon, but should always be such as is best suited for the part undergoing manipulation.
15. In bending over the patient, the body should be flexed
at the hips, not at the waist or shoulders. By this precaution the masseur may
avoid becoming round-shouldered. The height of the bed or couch should be such
that the masseur will not need to bend to any great extent.
16. Movements of the hands should always be executed from
17. Apply as much of the surface of the hands and fingers
as possible to the part operated upon, thus distributing the pressure and saving
18. The body should be gone over systematically, for which
purpose it should be divided into separate territories. Each part should be
finished before going to another part.
19. Opposite sides of the body should be manipulated in succession,
so as to intensify the effect upon the nerve centers.
20. The masseur should always keep in mind the anatomy of
the body, -- the outline of the bones, the location of the large nerves, arteries,
and veins, and of the principal muscular groups, -- and should take care to
follow the bones, thinking of the bony framework as well as its covering of
soft parts. Work down between the muscles and tendons, around the head of the
bones, taking special care to work into all the irregularities of the joints,
where the blood vessels and lymph channels are the largest.
21. At the beginning, movements should be slow and gentle,
being gradually increased in rapidity and force to the maximum, then gradually
diminished to the termination.
22. As a rule, always employ the same rate of motion for
the same movement. This indicates skill and good training.
23. It is well to run rapidly and lightly over a part before
giving the more vigorous movements.
24. In the first application of massage to a patient not
accustomed to treatment, great care should be taken not to produce soreness
and black-and-blue spots. These unpleasant effects are especially likely to
occur in fleshy and aged persons, owing to the feeble circulation in the adipose
tissues of the first class, and the brittleness of the blood vessels of the
second class. Fever convalescents and persons who have been long in bed are
also liable to these effects, for similar reasons.
25. For relief of sensitive parts, employ Only gentle stroking
over the affected areas, and administer derivative massage to the muscles and
other tissues of the vicinity, especially between the affected part and the
heart. The painful part may be approached by degrees until applications can
be made directly to it.
26. In many cases it is well to lubricate the hand with some
unctuous substance, such as olive oil, fine vaseline, cocoanut oil, or cacao
butter. The last-named substance is, perhaps, the best of all. It is solid at
ordinary temperatures, melting, however, at the temperature of the body. A cake
of cacao butter rubbed upon the hands occasionally during the administration
of massage, keeps the hands well lubricated without smearing the body of the
patient with a surplus of oil. In case oil is objectionable, talcum powder may
27. Lubricants should always be used when much pressure is
required, and where prolonged manipulation is necessary, also in the treatment
of parts where the skin is extremely sensitive.
28. When it is desired to stimulate the skin to a high degree
by friction, lubricants should be avoided. A part may be rubbed six to ten minutes
when oil is employed; but the same surface should not be operated upon more
than from two to five minutes when a lubricant is not used.
29. Some authorities recommend that the parts should be shaved
before the application of massage, but this is rarely necessary; and when the
treatment must be employed a long time, may become a source of serious inconvenience.
30. The amount of massage administered must be suited to
each case and to the mode of application.
31. Do not recommend massage for everything.
32. General massage should never be given in cases of fever.
.Local applications should not be made to parts which are the seat of acute
33. Fleshy persons do not bear massage well, for the reason
that the manipulations set free a large amount of waste matter and imperfectly
oxidized products which, absorbed into the system, produce the same effect as
excessive exercise,-effects resembling those of consecutive or secondary fatigue,
to which fleshy persons are very liable. Fleshy persons often complain of languor,
lassitude, and lameness after massage, and the tissues are very easily bruised
because of the weak circulation and on account of the excessive amount of adipose
tissue. Another cause of this condition is probably the disproportion existing
between the lymph spaces and the amount of waste matter set free, because so
much space is occupied by fat and subcutaneous tissue.
34. Massage is contra-indicated in nearly all forms of skin
disease, except in the thickened condition of the skin left behind by chronic
eczema. It is also contra-indicated in cases of apoplexy and in the early stages
of neuritis, when excessive irritability still exists, and should never be administered
to abscesses, tumors, or tubercular joints.
35. Order in General Massage . - (1) Arms; (2) Chest;
(3) Legs; (4) Abdomen; (6) Hips; (6) Back; (7) Head ; (8) Neck.
36. General Observations. - Percussion is sometimes more
effective in strengthening a weak muscle than either kneading or faradization.
37. Percussion and vibration should be avoided in hyperaesthesia.
In such cases, deep kneading, stroking, and joint movements may be employed.
38. Deep kneading is especially suitable for excitable neurasthenics
and patients suffering from chorea.
39. In infantile paralysis and other diseases accompanied
by lowered vitality and diminished activity without increased sensibility, percussion
40. In chorea and locomotor ataxia, - in fact, in most cases
in which massage is valuable, - gymnastics should, be added. In locomotor ataxia
the patient should exercise by walking and standing with the eyes closed, to
develop the coordinating centers.
41.In convalescence from fevers, massage must be applied
with care, because of the disturbance of the heat-regulating function on the
part of the body. The same is true in tuberculosis. Use chiefly friction in
42. Patients in whom the skin is rigid and inelastic, or
in a "hidebound" condition, may be prepared for general massage by the administration
of a warm bath.
43. In some patients the application of oil to the surface
is objectionable through the irritating effect of oleaginous matters upon the
susceptible skin, especially in persons subject to certain forms of skin disease.
In such cases we have found a glycerine ointment compounded after the following
formula, an excellent substitute: Glycerine, 15 oz. ; boracic acid, 1 1-2 oz.
; starch, 1 1-2 oz.; gum tragacanth, 1 1-2 oz. oil of wintergreen, 1 dr.
After lubricating the surface with the ointment, a little
moisture should be added by dipping the tips of the fingers in water. By means
of a moist towel this lubricant can be completely removed after the treatment,
leaving the skin delightfully smooth. Talcum powder is preferable in warm weather.