The Art of Massage
J. H. Kellogg, M.D.
Clinical Notes of Cases Treated by Massage.
In the following cases treated by myself and my colleagues
at the Sanitarium at Battle Creek, Michigan, massage, manual Swedish movements,
and gymnastics have been employed as the principal therapeutic means. Baths,
and usually some electrical applications, together with other appropriate
measures, have also been made use of, as in most cases treated in the institution;
but these particular cases have been selected to illustrate the effects
of massage, for the reason that in them more benefit was clearly attributable
to this agent, than to any other.
Obesity. - Mrs. W., aged fifty-three, was
received for treatment in February, 1893. She had always been inclined
to obesity, but had recently found herself increasing in weight so rapidly
that life had come to be almost a burden. This patient remained under treatment
six weeks, during which time, under vigorous massage administered daily,
she lost in weight at the rate of nearly one pound a day. Baths and a systematic
dietary were also used.
Mrs. A., aged twenty-five, was treated for obesity
for two weeks. At the end of two weeks she weighed fourteen pounds less
than at the beginning of treatment.
Col. X., aged fifty-three, weighed at the beginning
of treatment 334 pounds. He was naturally a very large man, but his weight
had been gradually increasing for more than twenty years; and when received,
he weighed fully one hundred pounds more than in health. As the result
of treatment during eight weeks, the patient's weight was reduced seventy-five
pounds. He was then obliged, by business engagements, to return home. He
came back the following year, when he was found to have regained in part
his former excess of weight; but a second course of treatment secured a
still further reduction of the enormous accumulation of flesh about the
trunk, which had given the patient's body most unwieldy proportions.
Emaciation. - Miss B., aged thirty-two, had
suffered from tuberculosis. A year in Colorado had effected a cure of the
tuberculosis, but had left a large cavity in the upper lobe of the left
lung. The patient had never recovered her normal weight or strength since
this illness, and within two or three years had been still further reduced
by uterine hemorrhages, until her condition had become very grave. Her
physician sent her to the Sanitarium with the hope that the hemorrhages
might be arrested and her general condition improved. She weighed less
than one hundred pounds, was extremely anaemic, and was so weak that it
was necessary to confine her strictly to bed for several weeks. At the
end of six months this patient had improved to such a degree that she was
enjoying better health than ever before in her life. Her weight had increased
forty pounds, and her strength had improved proportionately. Digestion
and all the other bodily functions were perfectly performed. The patient
returned to her home enjoying excellent health, and has remained well to
the present time, with the exception of an attack of la grippe.
Prof. W., aged sixty years, had been a dyspeptic
since he was twenty years of age, and had for many years been greatly emaciated.
He declared that his stomach was a "swill-barrel." He had been confined
to his bed for six months before coming to the Sanitarium for treatment;
and was then barely able to stand upon his feet. He could take a few steps
with assistance, but was obliged to use a wheelchair in going to meals.
During the first four weeks of treatment, this patient gained on an average
one pound each day, and at the end of six weeks was so greatly improved
that he walked a mile to the depot to meet a brother whom he had not seen
for several months, and who, as he afterward stated, had difficulty in
recognizing him, so greatly was his appearance changed for the better.
Many other similar cases might be cited. It is the author's custom to weigh
each patient at the beginning of treatment, and regularly every week thereafter;
and it is not an uncommon thing to find a patient who has gained three
to five pounds in a single week. From twelve to twenty pounds is very frequently
gained in the course of two or three weeks' treatment. Under the system
advocated in this work, the patient gains not merely in flesh, but also
in strength. A test of the strength is made at the beginning of treatment,
and each month while the patient remains under observation. A gain of five
hundred to six hundred pounds in strength capacity within four weeks is
very common, and sometimes double this amount is gained within a month.
Rheumatism. - Mrs. T., aged sixty, was received for
treatment in September, 1893. In addition to general debility, anaemia,
neurasthenia, dyspepsia, and disordered hepatic and renal functions, this
patient was suffering from rheumatism and with much stiffness of the left
shoulder. General tonic treatment, with general and local massage, especially
directed to the shoulders, entirely relieved the rheumatic affection in
Mrs. C., aged seventy, was received for treatment
in April, 1892. This patient had a fracture of the wrist which had been
treated by means of a plaster bandage. The whole arm was useless; the fingers
were extended and could not be flexed; the arm could not be raised as high
as the shoulder; only a very slight movement of the elbow joint was possible;
the entire arm was practically useless. The application of massage for
two months entirely restored the arm, so that it was stronger than the
other, as shown by the dynamometer. The patient, when she left, was able
to use the arm and fingers freely in combing her hair and for any other
Miss R., aged twenty-three, was received in March,
1891. She had suffered from lameness in the left arm for seven years, the
elbow being stiff, and the muscles of the arm considerably wasted. For
a year she had not been able to use her hand or arm at all, and all the
joints were more or less stiffened. The patient was under treatment for
five months, at the end of which time the restoration of the arm was nearly
complete. The motion of some of the joints was still slightly limited,
had good use of the arm, and suffered no pain.
Mrs. K., aged fifty-three, was received for treatment
in August, 1894. She had for several years suffered from stiffness of the
shoulder joints, the limitation of movement being accompanied by pain,
which was doubtless due to rheumatism. The disability was so great that
the patient had for several years been unable to dress herself without
assistance. At the end of one month's treatment, she was able to use the
affected arm nearly as well as the other; could move it freely in all directions,
lifting it above the head and placing it behind her, - movements which
had not been possible for more than ten years previous.
Neuritis. - Mr. X., aged fifty years, a carpenter,
had for several months suffered from severe pain in his left shoulder joint.
The muscles of the arm had wasted considerably, and the arm was wholly
useless; he could not even raise it from his side. He had evidently suffered
from neuritis of the nerves of the shoulder joint, and from muscular atrophy,
which usually accompanies this disease. Massage, with applications of fomentations
and electricity, effected a complete cure in the course of a few months,
and the patient has now for seven or eight years enjoyed the full use of
the arm as before.
Writers' Cramp. - Mr. A., aged twenty-seven
years, cashier in a bank, presented the most extreme and graphic picture
of writers' cramp which the author has ever encountered. The disease affected
not only the hand, but the entire arm and the muscles of the neck and face
; and spasms were excited, not only by writing, but by any movement of
the body. If the patient attempted to rise from a chair, his head was immediately
drawn to the right side, the right side of the face was contorted by muscular
contraction, and the muscles of the hand and arm became rigid. The patient's
gait seemed to be also slightly affected. He had submitted to several surgical
operations, in which some of the nerves of the neck had been divided, and
the sterno-cleido-mastoid and other muscles had also been twice divided.
Slight temporary relief had followed the operations, but the disease, when
the patient came under my care, was worse than it had ever been at any
previous time. Upon examination, I found that the patient was suffering
from all the different phases of writers' cramp. Whenever he undertook
to write, the whole arm became rigid, and the head was drawn around toward
the right side until the face looked nearly toward the shoulder. Strange
grimaces played upon the countenance in consequence of the contraction
of the facial muscles. Examination of the neck showed here and there points
of induration. Massage and gymnastics applied to the arm, and thorough
local massage of the muscles of the neck, together with revulsive applications
of various sorts, including dry cupping, hot and cold applications, and
mild counter-irritation, effected a complete cure; and the patient has
remained well until the present time, it being now some five years since
he was under Treatment. Apparently little or no benefit was derived from
other measures of treatment, nor until special attention was given to massage
of the affected parts and to the points of induration above 'referred to.
Many other equally successful cases might be cited from my experience,
in which not only local but general neuritis has yielded completely as
the result of the persevering and skillful application of massage.
Asthma. - Mrs. B., aged forty-one years, was
received for treatment in July, 1890, having suffered from nervous exhaustion
and asthma for many years. On examination, she was found to have prolapse
of the stomach and bowels, and extreme hyperaesthesia of the lumbar ganglia
of the sympathetic nerve. The patient was scarcely able to walk about,
and could not sleep on account of continued asthmatic paroxysms. During
the first two weeks after being received, she was confined in bed by asthmatic
attacks, which were extremely aggravated by the slightest exercise. Within
five weeks, however, the patient returned home wonderfully improved. The
asthmatic Paroxysms were especially relieved by percussion of the chest.
Spatting and hacking movements were found most effective.
Sprain. - Mrs. B., aged forty-four, was received
in August, 1893- for treatment for severe sprain of the ankle. Derivative
massage was applied at first; later, massage of the joint, including gentle
flexion and extension. At the end of ten days the patient was able to visit
the World's Fair. She had the misfortune, however, to sprain the ankle
again, and was obliged to return for treatment. At the end of two weeks
the ankle showed no trace of injury.
Miss M., aged twenty-nine years, was received for
treatment in August, 1893, being unable to walk in consequence of lameness
of the left ankle, the result of a sprain received some months before.
Massage was applied for several weeks, at the end of which time she was
able to walk with ease. Hot and cold applications, heating compresses,
local applications of electricity, and other means were also employed,
but the chief benefit was evidently derived from massage. A great number
of similar cases might be, cited.
The writer had a personal experience of the benefits
to be derived from massage in cases of sprain, which affords very conclusive
evidence of the value of this simple method of treatment when skillfully
administered in traumatisms of this character. The sprain involved both
the ankle and the metatarso-phalangeal joints, chiefly the latter. The
pain was so severe that it was impossible to sustain the weight of the
body upon the anterior portion of the foot. It was only possible to walk
by stepping in such a way as to keep the weight of the body over the heel
of the affected foot. Being much engaged, the sprain was neglected for
a couple of days, it being possible to hobble about after applying a tight
bandage about the foot, with the hope that nature would effect a cure;
but on the morning of the second day, it was found that the pain had become
so great that the whole foot was involved, and it was impossible to step
at all without very great pain. A masseur was accordingly sent for, and
derivative massage was applied with gentle friction of the foot and careful
joint movements of the ankle.
At the end of a couple of hours the pain had disappeared,
and in going about his usual duties, which require much exercise upon the
feet, the writer was greatly surprised to find that the sprain was practically
cured. No pain whatever. was noticeable, and it was, indeed, impossible
to place the foot in any position by which pain could be induced.
By the next morning, the third day following the
accident,. the foot seemed perfectly well. It was possible to run and jump,
and to hop upon the affected foot without pain. Several mishaps to the
foot caused a return of lameness before it was cured, but relief was invariably
found in the application of local and derivative massage.
If the ordinary method of absolute rest, without
massage, had been adopted, the writer feels confident that he would have
been a cripple for at least three or four weeks.
Spinal Curvature. - Miss R., aged fourteen
years, was suffering from double lateral curvature of the spine, with rotation.
The curvature had first been noticed two years before. After eight months'
treatment, the curvature had so nearly disappeared that the patient was
allowed to return home. Electricity, baths, and Swedish gymnastics were
employed in connection with massage.
Miss N., aged thirty-three years, was received in
February, 1891, for treatment of double lateral curvature of the spine,
-the result of sitting in a bad position in a large easy chair, a habit
which had been maintained for many years. The curvature was first noticed
five years previous. After five months' treatment the patient returned
home so greatly improved that the curvature was no longer a matter requiring
Miss B., aged twenty years, was received for treatment
in December, 1891, suffering from double curvature of the spine, with rotation,
-the result of an injury nine months before. In jumping from a wagon, she
had fallen upon frozen ground, dislocating one shoulder, and causing partial
paralysis of the arm and side. She was treated for a year and a half, wearing
a plaster jacket for six months; and, at the time she came under my care,
had worn a steel apparatus for six months. She complained of constant pain
in the side and shoulder. The patient's strength was so much improved as
the result of a few months' treatment, and the muscles of the trunk were
developed to such a degree, that she was finally able to dispense with
mechanical support of any kind. The total strength capacity was increased
more than one thousand pounds, as shown by the dynamometer.
Mr. K., aged thirty-five years, was received for
treatment in March, 1885. This patient had an extremely pronounced lateral
curvature of the spine, involving both the dorsal and the lumbar region;
rotation to the right also existed. The disease had begun about one year
previous, the chief symptom being severe pain in the right side. The muscles
were extremely contracted. By massage, exercise, suspension, local applications
of electricity, fomentations, and other measures of treatment, the patient
was, in the course of three months, entirely cured, so that he was able
to return to his business. His height was found to have increased two inches,
and no trace of the curvature remained. The most important measures of
treatment employed were massage and gymnastics, although the baths and
other means employed were doubtless to some extent beneficial.
Paralysis. - Mrs. K., aged forty years, had
been confined to her bed for many months as the result of paralysis of
one lower half of the body, resulting from a fall in which the back was
injured. After the daily application of massage for a few months the patient
was able to walk, and at the end of ten months' treatment was able to ride
a bicycle. Electricity, baths, and other measures were employed in connection
Scores of similar cases might be cited as illustrations
of the benefit to be derived from massage in cases of paralysis of different
forms. It is certainly of value, although not radically curative, in most
forms of paralysis. The writer has seen marked beneficial results from
massage in numerous cases of locomotor ataxia, and in a still larger number
of cases of spinal sclerosis, and other forms of paralysis arising from
degenerative processes in the general nervous system.
Infantile Paralysis. - Miss N., aged fourteen,
had paralysis of one leg and arm, as the result of an attack of poliomyelitis
when an infant. After several months' treatment by massage, with electricity
and baths, the patient was able to dance, skate, and make good use of both
arm and leg, although some evidences of the disease still remained.
Miss D., aged twelve, had suffered since infancy
from infantile paralysis affecting the left leg. When received for treatment,
the muscles below the knee were atrophied almost to complete disappearance.
No response could be obtained to the application of faradic electricity,
and only a slight one to the application of the galvanic current. The patient
had scarcely any use of the limb, and was able to make only very slight
movements of the toes. Her limb was constantly cold and moist. After one
year's treatment by massage, galvanism, and baths, the patient was able
to run about freely and make good use of the limb, and a very considerable
degree of muscular development had taken place.
Sclerosis. - Miss Z., aged twenty-six, entered
the Sanitarium as a patient in January, 1883. She complained of an inability
to use the right leg, having been compelled to use crutches in walking
for several years. On examination, the right leg was found to be in a remarkable
condition. Almost the entire limb had undergone such structural changes
that it had become as hard as wood. The tissues were considerably shrunken,
the surface was smooth as polished marble, the temperature was below normal,
so that the limb felt cold to the hand, and the ankle and all the joints
of the foot were fixed so that movement was impossible, although some mobility
still remained in the knee joint. Below the knee the limb could not have
been more rigid, hard, and lifeless in appearance if it had actually been
made of wood or celluloid. The case seemed an utterly hopeless one, but
the patient was so importunate that something should be done for her that
we received the case on trial for a few months.
At the end of three months the changes which had
occurred were truly remarkable. Above the knee the tissues had become quite
soft and pliable; below the knee the hardness was disappearing somewhat;
all the tissues of the foot were still hard, but the ankle and other joints
had loosened somewhat, so that slight. movement was possible. Continuance
of the treatment at intervals for two years restored the limb to such a
degree that the patient was able to walk without crutches, and scarcely
a trace of the former condition remained. The improvement continued for
several years. No relapse has occurred, and the patient at present
is in the enjoyment of excellent health, and the disability of the right
limb is comparatively slight. Electricity and hydrotherapeutic applications
of various sorts were employed in connection with massage, but the paramount
utility of massage in this case was unquestionable.
Constipation. - Mrs. H., aged thirty, was
admitted for treatment in April, 1887. She had been an invalid since confinement,
five years before, suffering from an aggravated form of dyspepsia and migraine.
No natural movement of the bowels had occurred for three years. The constipation
was entirely relieved by the employment of abdominal massage, together
with general tonic treatment and a correct regimen.
Miss H., aged twenty-two, had suffered extremely
for a number of years from constipation, a natural movement very rarely
occurring. At the end of two months' treatment the action of the bowels
had become normal and regular. The patient has been enjoying good health
Mr. X., a man of sedentary habits, had suffered from
constipation for many years. After two weeks' treatment a daily natural
evacuation of the bowels was secured without artificial means of any kind
other than massage, although a natural movement, had not occurred for more
than three years previous.
Mrs.. W., aged forty-four years, was received for
treatment in April, 1877, having suffered from extreme constipation for
more than twenty years. No movement of the bowels had occurred during this
time without the use of medicines. The lady's husband was entirely faithless
of any improvement under treatment, but at the end of three weeks the patient's
bowels were moving regularly, without tonic medicine of any kind.
Neurasthenia; General Debility. - Mrs. H.,
aged twenty-eight years, was received for treatment in June, 1893, having
been. an invalid for eight years. The patient had suffered greatly from
acid dyspepsia, flatulence, distention of the bowels, aortic palpitation,
and extreme constipation, with great hyperaesthesia of the lumbar ganglia
of the sympathetic. The lower border of the stomach was found three inches
below the umbilicus, also a floating kidney on the right side, and both
ovaries prolapsed. Indeed, the conditions were sufficiently grave to render
a person thoroughly miserable. The patient remained under treatment five
months, during which time she received daily applications of massage, especially
to the bowels, and electricity. At the end of five months she left the
Sanitarium enjoying very comfortable health.
Haematuria and Anaemia. - Mrs. L., aged thirty-eight,
was received for treatment in June, 1892. The patient was extremely anaemic,
as the result of several months' suffering from a very aggravated form
of haematuria. Her face was without color; she was emaciated, and so weak
as to be confined to her bed. She could only be moved upon a stretcher
or wheel-chair, from which it was necessary to lift her to the bed. She
was able to walk at the end of three weeks, and left. at the end of two
months, entirely cured. She had gained greatly in flesh, and the natural
color had returned to her cheeks. The patient pronounced herself entirely
well. The haematuria ceased within a week after the beginning of treatment.
Anaemia. - Miss A., aged twenty, had suffered
from a variety of troubles which had resulted in a very grave form of anaemia.
The chief of her troubles were chronic inflammation and prolapse of the
left ovary; movable right kidney; enteroptosis and gastroptosis, the lower
border of the stomach falling one inch below the umbilicus; extreme hyperaesthesia
of the lumbar ganglia of the sympathetic; menorrhagia; and frequent attacks
of acute gastritis. Strong anaemic murmurs were found at the base of the
At the first examination the patient's nutrition
was found to be reduced to such a low point that the hemoglobin present
was only four per cent -less than one third of the normal amount. The number
of blood corpuscles per cubic millimeter was 1, 51 0, 000, or one third
of the normal. Poikilocytes and microcytes -were exceedingly abundant,
and there were a few macrocytes. This case, if not one of pernicious anaemia,
certainly bordered very closely on that class of anaemics. Under rational
treatment, by which massage, both manual and mechanical, was a leading
feature, the amount of haemoglobin increased in ten days to seven per cent,
and the blood count to 2,340, 000 per cubic millimeter. A few macrocytes
and poikilocytes still remained, showing that normal haematogenesis was
not yet restored, but that the process was becoming normal.
A marked feature in this case was the small number
of leucocytes contained in the blood. At the first examination the proportion
of leucocytes to normal was only eighteen one hundredths; at the end of
ten days the proportion had increased to fifty-four one hundredths. At
the end of a few weeks' treatment the blood count was 3,210,000 and the
haemoglobin eight per cent, as measured by Henocque's haematoscope. The
patient's improvement remained permanent, and at the present writing she
is still improving.
Mrs. Z., aged twenty-five, was received at the Sanitarium
for treatment in October, 1894. She had suffered for two years from marked
anaemia, as the result of an attack of intermittent fever. On arrival,
the examination of the blood gave the following results: Blood count, 3,760,
000; haemoglobin, 10. 5 per cent.
Four weeks later a second examination showed an
increase of the blood count to 3,930, 000. The percentage of haemoglobin
was the same as at the first examination.
At the end-of two weeks' further treatment, during
which the patient made rapid gain, the blood count was found to be 4,370,
000, and the haemoglobin twelve per cent. The patient went home much benefitted,
and with a prospect of continued improvement.
Melancholia. - Mrs. B., aged thirty-one, was
received for treatment in July, 1893. The patient was in an extremely weak
and emaciated condition, and had been insane for three and a half years,
as the result of a fright caused by the explosion of a lamp in a sleeping-car.
For six months, marked suicidal tendencies had existed. After six months'
treatment the patient returned to her home perfectly sound in health, mentally
and physically. She has remained well up to the present time.
Prolapsed Liver. - Mrs. N., aged fifty, was
received for treatment in July, 1891. The abdominal muscles were found
greatly contracted; but after the administration of massage for two weeks,
the muscles became relaxed sufficiently to allow a minute exploration of
the condition of the viscera, when a mass was found in the right side which,
on further investigation, proved to be a prolapsed liver. This organ was
daily replaced, in connection with abdominal massage, At the end of three
months the patient returned to her home enjoying good health, the abdominal
muscles well developed, and the liver in its normal position.
Such encouraging results as these cannot be obtained
in every case, although almost equally good success has been reached in
a number of others which have come under the writer's care. In a recent
case the abdominal muscles had been so overstretched by repeated pregnancy,
and had become so relaxed and wasted by disuse, that little could be accomplished
by means of massage.
The pyloric end of the stomach was in this case
found three inches below the umbilicus, the lower border of the liver falling
an inch below the umbilicus. Finding it impossible to support the organs
in position by abdominal bandages or supports of any kind, and despairing
of relieving the patient in any other way, the following surgical procedure
was adopted: It being necessary to perform an operation upon this patient
for the relief of an irreducible direct inguinal hernia, in which a mass
of omentum had become incarcerated, I determined to make an attempt at
the same time to restore the prolapsed stomach and liver to position by
surgical means. An incision was accordingly made from a point one inch
below the ensiform cartilage of the sternum nearly to the umbilicus. Passing
two fingers downward through this incision, it was, just possible to reach
the lower border of the liver, which was forced up into its position under
the ribs. The pyloric end of the stomach was drawn up to nearly its normal
position, and by means of four silkwormgut sutures inserted along the line
of the lesser curvature of the stomach (including, of course, only the
perineal coat) near its pyloric end, the organ was attached to the abdominal
wall. The sutures were passed through the inner margins of the wound at
its upper part, so that when tied they not only attached the stomach to
the abdominal wall, but also brought together the edges of the peritoneum
and the divided fascia. The sutures were buried in the wound by the closing
sutures, being cut off short to remain permanently. The position of the
sutures was made such as to cause them to fall at the notch between the
right and left lobes of the liver, and thus serve as a means of supporting
it in its normal position. The patient had no febrile reaction whatever
following the operation, and was greatly improved by it, the stomach and
liver being held in nearly normal position. Three weeks after the operation
she was able to eat heartily, and the lower border of the stomach was found
an inch above the umbilicus, instead of three inches below it.
Prolapsed Stomach and Bowels. - Mrs. A., aged
twenty-seven, was received for treatment in July, 1891, The patient was
very weak, anaemic, and nervously exhausted. Digestion was almost totally
suspended. Upon examination, the lower border of the stomach was found
two inches below the umbilicus. Special applications of massage to the
abdomen; replacement of the stomach; and the employment of general massage,
electricity, and baths restored the patient to complete health. At the
end of six months the abdominal muscles were found to be vigorous and well
developed. The stomach was held in normal position. The patient has since
remained in good health.,
After a thorough application of the procedures described
elsewhere in this work for replacement of the stomach and lifting of the
abdominal contents, the writer has frequently been able to demonstrate
the lower border of the stomach at a point from two to four inches above
the point at which it was found at the beginning of the treatment.
Pelvic Disease and Constipation. - Mrs. T.,
aged thirty-two, had suffered for a number of years from severe constipation,
extreme tenderness of the ovaries, uterine prolapse, and a variety of nervous
symptoms arising from these conditions.- At the end of four months' treatment,
the patient returned home cured of the constipation and of her pelvic disorders,
and has remained in good health ever since.
A large number of cases similar to the above might
be cited, illustrating the beneficial results following the use of massage,
both general and local, in cases of chronic constipation in its different
forms. It is needless to remark that in the treatment of this class of
cases, manual Swedish movements, gymnastics, and a proper regulation of
the dietary are always combined with massage. In some instances, also,
the sinusoidal electric current is employed, the chief value of this agent
in these cases being the rhythmical exercise secured by it for the abdominal
and other voluntary muscles which come within the influence of the application.
Mrs C., aged thirty-four, was received in February,
1890. The patient had been an invalid for ten years, her ailments dating
from the birth of her first child. She was nearly bedridden, emaciated,
sallow, depressed, extremely nervous, and a constant sufferer from severe
pain in the abdomen and pelvis, the result of chronic peritonitis. The
abdomen was so tender that at first scarcely the weight of the hand could
be tolerated. After a few weeks the patient was able to endure vigorous
manipulation of the abdomen, also pelvic massage. She remained under treatment
eleven months, at the end of which time she returned to her home restored
to good health. Vaginal douches, fomentations to the abdomen, and applications
of electricity were also used in connection with the massage.
Ovarian Disease. - There is no class of functional
disorders more amenable to the intelligent application of massage than
disease of the ovaries. A great number of cases-.some scores - might be
quoted in demonstration of the truth of this statement. A few typical ones
only will be cited.
Miss W., aged twenty-four, was admitted as a patient
in September, 1892. She had spent the greater part of her life in boarding
school, where she had been subjected to the usual deteriorating influences
of boarding-school life. Examination showed that, in addition to a very
marked anaemia and a great variety of neurasthenic symptoms, there was
also a posterior curvature of the spine at the middle dorsal region, resulting
in extreme flatness of the chest and abnormal prominence of the abdomen,
marked hyperaesthesia of the abdominal sympathetic and pneumogastric; stomach
and bowels sunken; left ovary prolapsed, enlarged, and extremely tender;
severe dysmenorrhoea and menorrhagia, menstrual flow lasting a full week;
and constant backache. She had had two attacks of pelvic inflammation;
could take no exercise at all without inducing severe pelvic pain; for
the last year and a half had been receiving treatment of the eyes from,
an eye specialist, who labored under the belief that muscular asthenopia,
or eyestrain, was the cause of all the symptoms. She grew steadily worse,
however, instead of better, although several operations were performed
upon the, muscles of the eye. At the end of three months the patient declared
she felt stronger and better than ever before in her life. The pelvic inflammation,
ovarian congestion, and other local disorders have entirely disappeared.
The curvatures of the spine, which were wholly due to unbalanced muscular
action, were cured. The total gain in strength was 1029 pounds, the increase
being from 1582 to 2611. The patient returned to her home with rosy cheeks
and ruddy lips, giving no evidence, either objective or subjective, that
she was enjoying other than perfect health.
Miss H., aged twenty, entered the Sanitarium Hospital
as a Patient with the expectation that the ovaries would have to be removed,
as they had been a source of great pain and suffering. She had been bedridden
most of the time for three years. There was extreme pain in the left leg,
which seemed to proceed from the left ovary; also in the left ovarian region;
the uterus was anti-flexed and retroverted ; the patient generally feeble
and anaemic. A sear in the median line below the umbilicus was evidence
of the fact that she had had, some months previous, an abdominal section
performed, the purpose of the operator having been to remove what he supposed
to be a diseased left ovary. A disagreement between the two physicians
who were in charge of the case at the time of the operation, as to whether
or not the ovary was sufficiently diseased to require removal, led to a
conclusion of the operation as an exploratory incision. I took care to
restore the prolapsed ovary to position, and replaced the uterus, supporting
it by means of a suitably adjusted pessary, and rendered the replacement
permanent by shortening the round ligaments. Under the influence of massage
and proper exercise, coupled with local applications of electricity, vaginal
douches, etc., the patient made an excellent recovery, and escaped mutilation
by the removal of the ovaries.
Miss. S., aged twenty-five, arrived at the Sanitarium
in a wheel chair, pale, weak, thoroughly discouraged - an invalid, - having
been in bed for nearly three years and for two years unable to sit up long
enough to take a single meal. The patient was extremely neurasthenic, anaemic
to a marked degree, emotional, hysterical, and had constant ovarian pain,
which was very greatly increased at the menstrual periods; bowels were
constipated; gastric and intestinal catarrh were present. The patient was
so susceptible to cold air that she was constantly muffled up in warm blankets,
and the slightest draught gave rise to extreme neuralgic pains in various
parts of the body.
An examination of the stomach fluid showed hyperpepsia,
Physical examination discovered no disorder of the heart or lungs, but
extreme hyperaesthesia of the abdominal sympathetic; great pelvic congestion,
which was indicated by the almost universal throbbing of the pelvic vessels,
the uterus being enlarged to more than twice its normal size, and in a
state of extreme retroversion; prolapsus and tenderness of the ovaries,
each being twice the normal size; extreme tenderness and irritability of
all the pelvic viscera, with general prolapse of the abdominal organs.
This patient had been under the care of physicians
for many years. For the last two years she had been under the care of eminent
metropolitan physicians, who had employed "rest-cure, " and the various
methods of treatment commonly adopted in such cases, but without benefit;
in fact, the patient had steadily grown worse. She was brought to the Sanitarium
from a hospital in Chicago, where she had spent some time, but without
receiving help. Massage, manual Swedish movements, and exercise with a
wheel-crutch were employed, together with replacement of the uterus and
ovaries, and pelvic massage twice a week.
As the patient gained strength, she was required
to take more vigorous exercises from day to day; and at the end of six
weeks her wheel-chair was taken from her, and regular walking exercises,
with the aid of the wheel-crutch, were instituted. At the end of two months
the blood had become normal, the amount of haemoglobin being fourteen per
cent, as shown by Henocque's haematoscope. The right ovary was still enlarged
and somewhat tender, and had a disposition to prolapse; the left ovary
was not at all tender, and remained in place. Less than four months after
the patient's arrival, the uterus was normal in size and position. Neither
ovary could be felt. The patient still complained occasionally of pain
in the right ovarian region, but had so far recovered that she was able
to begin to ride the bicycle; and since that time has made steady improvement.
Her total strength was 2558 pounds, a gain of more than one thousand pounds.
The patient was able to exercise freely, and to go about on her feet all
day like a well person, and could ride seven or eight miles on a bicycle
without the slightest inconvenience. The general sagging of the viscera,
although a very noticeable feature at the beginning of the treatment, had
entirely disappeared. The bowels were well held up; the lower border of
the stomach had risen two inches; and the patient was discharged as cured.
She has remained well.
Miss D., aged twenty-two, came to the Sanitarium
a very frail, undeveloped woman, a victim of nervousness, spinal irritation,
and a multitude of symptoms, one of the worst of which was so-called muscular
rheumatism. She had never in her life enjoyed good health. Menstruation
was irregular, accompanied by extreme pain; uterus anteflexed, in a state
of retrocession; left ovary prolapsed and tender; profuse leucorrhoeal
discharge. At the end of six weeks the patient had increased in weight
from eighty-six to ninety-six pounds, and had gained 500 pounds in strength.
Her waist measure had increased one inch. Her countenance, formerly sallow,
was now fresh and full of color; cheeks plump; and her appetite, which
had been almost wholly absent, was now so excellent as to oblige her to
leave the table hungry, to avoid overeating. The patient was no longer
depressed, but wore a happy, cheerful face, being as "busy as a bee" all
day long, working for the health and vigor which she already enjoyed in
greater measure than ever before in her life. Pelvic massage was administered
twice a week. The result was complete relief from ovarian tenderness and
Miss K., aged twenty-one, had suffered from constant
backache, and was very nervous; had been for some time a student, but had
become so ill that her studies were seriously interfered with, and she
was unable to endure any physical exertion. Examination showed extreme
tenderness of the spine, retroversion of the uterus, prolapse and tenderness
of the ovaries, and, as usual in such cases, prolapse of stomach and bowels.
The patient was under treatment for several months, during which time she
continued her studies, when her health became so greatly improved that
she entered the employ of the Sanitarium as a nurse. She now enjoys better
health than ever before in her life. Her waist, which had been compressed
by tight bands and corsets, expanded several inches as the result of physical
exercise, and the vigor of respiration increased to such an extent that
the waist enlarged fully six inches in taking a deep breath. Her waist
measurement has increased four inches. The ovarian tenderness has disappeared,
and not the slightest uterine displacement remains. There is no longer
any complaint of backache, and the patient enjoys almost perfect health.
Miss T., aged twenty-two, had suffered constantly
from great distress in the head, mental confusion, extreme nervousness
and lassitude, backache, and severe dysmenorrhoea. The patient had been
so long a sufferer that she had lost all interest in life, - a fact which
was clearly indicated by her dejected and hopeless countenance. On examination,
I found the uterus and ovaries pro-. lapsed, and the ovaries tender. The
patient had worn a corset since fifteen years of age. The waist measure
was 23.5 inches; waist expansion, with clothing entirely loose, 1. 3 inches.
The abdomen was sagging, and general visceral prolapse existed. The patient
was so feeble that her aggregate strength was but 832 pounds. At the end
of two months' treatment, by the methods previously outlined, this patient's
total strength was increased to 1600 pounds, or nearly doubled. There was
an increase of one and one half inches in waist measurement, and general
improvement in every particular. Ovarian irritation, which was very marked
at the beginning of treatment, had entirely disappeared. The patient soon
entered the Sanitarium Training School for Nurses, and has since done very
efficient work as a nurse. She has now (1894) fol lowed her profession
for five years, and is enjoying excellent health. At the end of one year
from the beginning of treatment, and several months after the treatment
and training had been discontinued, her aggregated strength was found to
be 3031 pounds. Her waist measure had increased to thirty inches. There
was a marked gain in the lung capacity, and the patient's entire appearance
had undergone so decided a change that she could scarcely be recognized
as the same person. The sallow complexion had disappeared, and a fresh,
ruddy countenance had taken its place. The air of lassitude and dejection
previously worn was wholly gone, and an expression of energy, vigor, and
cheerful content had taken its place. The increase of strength in the several
regions of the body, in this case, was so interesting as to be worth noting.
The total increase in strength of arms was from 257 to 855 pounds; in the
legs, from 251 to 1058 pounds; in the trunk, from 161 to 712 pounds ; in
the chest, from 164 to 406 pounds: by which it appears that the arms had
increased in strength seventy per cent; the legs, seventy-six per cent
; the trunk, seventy-seven per cent; and the chest, or respiratory muscles,
sixty per cent. The greatest gain was in the trunk muscles, which I have
almost uniformly found to be the case, as this is the weakest point with
women suffering from displacement of the abdominal and pelvic viscera.
Figures 93 and 94, Plate XXXIV, show the change which took place in this
young woman's figure as the result of her treatment.
Miss T., aged twenty-one years, had been a miserable
invalid for a number of years, having suffered extreme pain at the menstrual
period, and being subject to constant headache, a great number of neurasthenic
symptoms, and extreme nervousness. Examination showed the following conditions:
Prolapse of stomach and bowels; movable right kidney; great tenderness
of the abdominal sympathetic, and especially of the renal plexus and lumbar
ganglia; the uterus in an abnormal position, and the left ovary prolapsed
and exceedingly sensitive; congestion of all the pelvic viscera. After
a few months' treatment, in which massage and exercise were the most prominent
agents, although electricity and other means were employed, the patient
returned home enjoying perfect health. The ovaries were in position and
not sensitive. The stomach and bowels were elevated to nearly their normal
position. The right kidney remained in place so long as the patient maintained
a correct posture. Her stomach, which had been exceedingly foul, was clean,
and the patient was relieved of all her previous symptoms of ill health.
Since that time, now some three years she has been constantly engaged in
ordinary household employments without injury. In this patient the total
strength increased in three months from 1004 pounds to 2647 pounds. The
waist measure increased two and one half inches.
Miss L., . aged twenty-two years, had for a number
of years been a student at a boarding school. At the time I first saw her,
she had been for several years a confirmed invalid, had suffered extremely,
and was very nervous. I think I have never met a patient who suffered more
severely from menstrual pains and dysmenorrhoea. She was so reduced in
flesh as to be scarcely able to walk; had been under the care of leading
New York gynecologists, but without benefit. At the end of twelve months,
by the careful employment of massage and other measures, with physical
training she returned home the picture of health, free from pain, without
ovarian tenderness, which had been extreme, and able to walk several miles
without injury or discomfort. Two months later she resumed her studies
in the advanced classical course of a well-known college.
Miss A., aged twenty-six, had been a confirmed invalid
for a number of years; had suffered from severe dysmenorrhoea, and the
menstrual pain was increasing from month to month. She had become extremely
nervous, hysterical, and generally hyperaesthetic. Examination showed tenderness
of the spine the whole length, the slightest touch being extremely painful;
and the same was practically true of all portions of the body. The uterus
and both ovaries were prolapsed, and the latter were extremely sensitive.
There was also prolapse of the stomach and bowels. In addition to the symptoms
mentioned, the patient was subject to very severe headaches, a symptom
which I have found very common in these cases. I believe these headaches
to be due, however, not to the ovarian disease, but to the accompanying
stomach disorder, for the relief of which massage and careful regulation
of the dietary are among the most efficient means of treatment. This patient
was under treatment for four months, during which time physical culture,
massage, Swedish movements, hydrotherapy, and electricity were employed,
either in conjunction or consecutively, and with the result that at the
end of the period named, I was able to send the patient home to her friends
in excellent health. The menstrual suffering had entirely ceased. The patient's
flesh and blood had increased so that she had become the picture of health.
There was still slight ovarian tenderness, but it was disappearing so rapidly
that there was every reason to believe it would be entirely gone in a very
short time. Unfavorable conditions caused a partial relapse after the patient
reached home, but a return to the same methods of treatment resulted ultimately
in complete and permanent recovery.
Miss B., aged thirty-six years, entered the Sanitarium
in February, 1893. She had never been well, and was so weak, anaemic, and
emaciated that she was supposed to be suffering from serious lung trouble,
for which she had been under treatment for some time. Diagnosis of some
pulmonary disease was favored by a night cough. Examination showed the
following conditions: Prolapse of the stomach; hyperaesthesia of the left
lumbar ganglion and solar plexus; right kidney floating; both ovaries extremely
sensitive. Examination of the stomach fluid showed hyperpepsia, with fermentation.
After less than two months' application of massage and other treatment
appropriate to the case, the patient went home improved in every particular;
in fact, was so greatly changed for the better that she considered herself
in excellent health.
Miss E,, aged twenty-four, entered the Sanitarium
in August, 1892. She had been a chronic invalid for many years, and had
despaired of recovery. Her principal symptoms were general nervousness,
exhaustion, and severe pelvic pains. Local examination showed left ovary
to be extremely sensitive and prolapsed. The patient remained under treatment
a little less than three months, at the end of which time she returned
home with no trace of pelvic disease, and enjoying excellent health. This
patient nearly doubled her muscular strength while under treatment, the
aggregate lifting capacity of the muscles being increased from 1365 to
2350 pounds. In this case, as in a great majority of those of this kind,
the greatest proportion of gain was in the muscles of the trunk, The gain
in strength for the several parts of the body was as follows: Arms, from
414 to 571 pounds; legs, from 674 to 1168 pounds; trunk, from 197 to 451
pounds; chest, from 80 to 160 pounds. Massage of the muscles of the trunk
and abdomen plays a very important part in a systematic course of treatment
for the development of this part of the body, the weakness of which is
one of the principal causes of disease in women.
Miss B., aged twenty-five, entered the Sanitarium
as a patient in July, 1891. She had been more or less an invalid ever since
her twelfth year, having suffered from pelvic inflammation at various times,
and from the beginning of menstruation at the age of twelve, from severe
menstrual pain. Examination showed retrocession of the uterus; ovarian
sensitiveness and congestion; prolapsed stomach and bowels; and floating
right kidney. By the employment of abdominal massage, manual and mechanical
Swedish movements, and a carefully conducted course of physical training,
together with other appropriate treatment, the patient was, at the end
of four and a half months, able to leave the Sanitarium in the enjoyment
of very good health. The menstrual pain had ceased; ovarian irritation
had disappeared; the stomach and bowels were well held in position, and
there had been a gain in strength of from 1600 pounds to 3000 pounds. The
gain in symmetry was even more remarkable than the gain in physical strength,
as is well shown by the physical chart obtained in this case (Chart I).
The radical improvement made in this patient's health has been permanent.
Miss. T., aged thirty-three entered the Sanitarium
as a patient in September, 1892. She had been an invalid for a long time;
had suffered greatly,from ovarian pain and the usual accompanying symptoms,-general
neurasthenia, hyperaesthesia of the spine, and hysteria. The patient was
in an extremely wretched and helpless condition. In two months she returned
to her home, having been absolutely free from pain for several weeks and
with entire relief from pelvic symptoms.
Miss X., aged forty-three, was received at the Sanitarium
as a patient in July, 1893. She had been an invalid since her sixteenth
year; had suffered from menstrual pain and leucorrhoeal discharge; right
kidney palpable and sensitive; stomach prolapsed; uterus in retrocession;
right ovary prolapsed and tender; left ovary prolapsed and very sensitive,
and more than double the normal size. The slightest attempt to replace
the uterus and ovaries gave extreme pain. At the end of six weeks, the
patient had gained several hundred pounds in strength. The pelvic pains
had disappeared. . The digestion, which had formerly been very much disturbed,
was greatly improved, and the patient had begun to enjoy good health. Pelvic
and abdominal massage played the most important part in the cure of this
Miss M., thirty-two years of age, became a patient
in the institution in July, 1893. She had suffered for years from a great
variety of nervous disturbances, which were mostly neurasthenic in character.
Some of the most troublesome symptoms were a severe burning sensation of
the spine, a constant ringing sound in the head, and great distress at
the base of the brain. She had suffered also from severe dysmenorrhoea.
On examination, I found the stomach prolapsed; extreme sensitiveness of
the left lumbar ganglion of the sympathetic; right kidney movable; left
ovary large, prolapsed, and tender. Examination of the stomach fluid showed
that the patient was suffering from hyperpepsia, with fermentation. General
and local massage, abdominal massage, Swedish gymnastics, apparatus work
in the gymnasium, also general and local baths, applications of galvanic,
faradic, and the sinusoidal electrical currents., together with the establishment
of a suitable dietary, resulted in the restoration of this patient to good
health in the course of a few months.
Miss H., aged seventeen, came to the Sanitarium in
December, 1893. This patient was sent from a distant State by her physician,
for the removal of the ovaries, as she had suffered from severe dysmenorrhoea
from the very beginning of menstruation, which first appeared two years
previous, at the age of fifteen. The periods were irregular, the flow profuse;
and pain, which was excruciating during the menstrual period, was constantly
present between the periods to such an extent that the patient was practically
disabled. The patient complained of a dragging sensation in the pelvis,
and what her family physician believed to be an abscess of the left ovary.
Examination showed anteflexion of the uterus, with extreme sensitiveness
of both ovaries. The patient also suffered from indigestion, was extremely
anaemic, and weak; and she, as well as her parents, was very desirous that
the operation of ovariotomy should be performed without delay. Indeed,
the patient seemed very much disappointed when I informed her that I thought
ovariotomy not necessary in her case, but that she could probably be cured
without the adoption of any such radical measures. Curettement relieved
the profuse flow. The patient was gradually gotten upon her feet, and trained
to active exercise in the gymnasium, taking daily breathing exercises,
Swedish gymnastics, apparatus work, and mechanical Swedish movements, in
addition to massage, baths, and electrical applications. Especial attention
was given to pelvic massage, which was certainly a very important agent
in securing a rapid disappearance of painful symptoms. In fact, the patient
improved so rapidly that. within a month all thought of a serious surgical
operation was abandoned.
A little more than five months after her arrival,
the patient was dismissed. She no longer suffered from pain at her menstrual
periods, or at any time; had gained twenty pounds in flesh; and gave every
indication of the enjoyment of absolutely perfect health, which condition
continues to the present time.
Miss S., aged twenty-nine., was received in June,
1894. For the last eight months she had suffered extremely from constant
pelvic pain. The spine was extremely sensitive; all the pelvic viscera
were congested; the patient complained of a bearing-down pain, constant
and severe headache, neuralgia and a great variety of nervous symptoms.
She was extremely anaemic and very weak, having been confined to the bed
for nearly six months; had also severe dysmenorrhoea and menorrhagia. She
had suffered several attacks of severe pelvic inflammation, and had steadily
grown worse for months, until recovery was almost despaired of. Examination
of the urine showed renal insufficiency, the amount of urea eliminated
being but 5.86 grams, while the total solids were 18.63, indicating tissue
waste and deficient elimination. Digestion was very greatly disturbed;
there was no appetite. The patient was much emaciated. The same measures
employed in the preceding case were adopted in this case also, and with
equal success, although the progress was not quite so rapid.. Especial
attention was given to abdominal and pelvic massage. The stomach symptoms
were relieved by a diet of kumyss (New Era Kumyss). The following notes
were made of the case two months after the patient was received for treatment:
"Her appetite is good; she is able to take ordinary
food, has gained in flesh; the menorrhagia has disappeared, also the neuralgia
and general neurasthenic symptoms; the patient is well established on her
feet, and no longer suffers from ovarian pain either at the menstrual period
or at other times, and expects to return in a short time to her field of
labor as a foreign missionary. " The patient has since remained well.
Miss C., aged thirty, was first examined in June,
1892. The patient's general health was fair, but she had suffered for many
years from severe dysmenorrhoea and constant ovarian pain, which had in
part disabled her, so that she was not able to do ordinary housework, which
had been her occupation. The patient, did not at that time come under the
writer's care for treatment, but fell into the hands of other physicians.
In June, 1894, she was sent to me by her physician for the performance
of the operation of ovariotomy, constant treatment having failed to cure
her, or to prevent a steady decline. On examination, I found she was in
every respect worse, having been for a year completely disabled. The ovaries
were much enlarged, prolapsed, and sensitive. All the tissues about the
uterus were in a hypersensitive condition, and the pelvic vessels throbbing.
The patient was placed under treatment similar to that employed in other
like cases, special prominence being given, however, to pelvic massage,
which was employed every other day. After the third treatment the patient
was relieved to a very marked degree, and after three weeks' treatment
she was able to engage in vigorous work in a laundry, doing both washing
and ironing, which she had not been able to do for more than two years.
The menorrhagia and dysmenorrhoea, which had been very severe, had entirely
disappeared. She was not obliged to stop work even during the menstrual
period, although previously for several years she had been obliged to call
a physician, and had habitually taken morphia at that time to relieve the
severe menstrual pain. The patient's improved health has continued to the
present time (April, 1895), and she pronounces herself in perfect health.
When medical men come to appreciate the fact that
patients, not simply maladies, are to be treated; that the
woman suffering from functional ovarian disease needs, not simply the treatment
of her diseased ovaries, but to be made a better "animal, "-a more vigorous,
less sensitive, and more highly vitalized woman, -a vast number of women
who now languish on beds of suffering, or drag out lives made miserable
by chronic invalidism and perpetual local treatment, will be restored to
health and usefulness; and a very large number of young. women who are
now subjected to the operation of ovariotomy, will escape the surgeon's
knife, and become. happy wives and mothers. Massage, manual Swedish movements,
and gymnastics will be found to contribute more to the care of these cases
than any other one class of therapeutic means.
Fractures. - Mrs. P -, a lady about forty
years of age, in attempting to enter a street-car, slipped and fell upon
the ice, breaking the tibia and fibula just above the right ankle joint.
The displacement was very great, and the ligaments were torn to such an
extent that it was impossible to restore and maintain, perfect symmetry
of the limb, although. this was accomplished as perfectly as possible by
means of a properly adjusted splint. Fomentations were applied for an hour
or two before the application of the splint. A snug bandage was then applied
to the limb, and the splint adjusted. After the fourth day the splint was
removed daily, fomentations or hot and cold applications were made, and
massage was carefully administered (for method see page 51 and paragraph
385). The case looked to be a very unpromising one, but an excellent recovery
occurred. In a few weeks the patient was on her feet, and after a few months,
during which time massage was quite persistently employed, the function
of the joint was perfectly restored. The ankle joint was not at any time
allowed to become stiffened by disuse.
Ununited Fractures. - Mr. A -, a young man aged thirty
years, from Idaho, presented an ununited fracture of the humerus, the result
of a gunshot wound. About two inches of bone had been lost shortening the
humerus to that extent. Three operations had been performed, two of them
by distinguished surgeons, but the fracture was still ununited. The muscles
had wasted away, and the arm was practically useless. The elbow joint was
completely stiffened as the result of long immobilization, to which the
arm had been subjected. The patient was apparently in fair general health,
but he was nevertheless subjected to a course of vigorous tonic baths,
special attention being given to the improvement of the nutrition of the
arm by means of fomentations, the hot and cold douche, and especially by
the application of massage. After a few weeks an incision was made, and
it was found that there had been no attempt whatever at union, though the
ends of the bone had apparently been nicely adjusted and secured together.
The ends of the bone were irritated by erosion, and another wire was introduced
at right angles to the first. The wound was closed, and motion was restored
to the stiffened elbow by forcible flexion and extension. The wound healed
by immediate union, and at the end of a week the baths and massage were
resumed with the result that solid union was obtained, and the patient
sent home with a useful arm.
Mr. H aged twenty-six years, sustained a severe compound
fracture of the left humerus as a result of a railroad accident. He was received
into a hospital in the Eastern city where the accident occurred. After a few
weeks he was discharged, but upon subsequent examination it was found that no
union had taken place. The patient urged an operation, but instead was encouraged
to believe that union might be secured by means of massage, which was applied
daily, and with the result that at the end of three months solid union had been
obtained, and a few months later the patient pronounced his arm as good as ever.
The arm was not immobilized, but care was taken to give it some support by means
of a sling, so that an excessive amount of motion might not occur at the point
The philosophy of this method of treating fractures is that
it improves the nutrition, encourages the circulation, and stimulates all the
vital activities of the affected parts, and thus promotes a healthy and efficient