The Art of Massage
J. H. Kellogg, M.D.
The so-called Schott method of treatment, employed
by the Schott brothers, of Nauheim, Germany, in connection with the effervescing
chloride of calcium baths, has acquired a great reputation, not only in
Germany, but in England, where it is now much in vogue, especially in hospitals
While this method is as yet little employed in this
country, and seems to have been practically unknown in Germany until introduced
by the brothers Schott, it is but fair to state that it presents no, features
essentially different from the system of manual Swedish movements which
has for more than fifty years been employed in Sweden, Norway, and Denmark,
by the practitioners of the so-called Ling, or Swedish, system of curative
Although we have no definite knowledge upon the
subject, we feel confident that careful inquiry into the origin of the
"Nauheim treatment" would show it to have been derived from the Swedish
system. Great credit is due to the Schott brothers for having so thoroughly
systematized the method, and for having by persevering and successful effort
brought it to the attention of the medical profession in so favorable a
manner as to command attention and respect. Under this form, the writer
has for the last twenty years employed gymnastics in the treatment of cardiac
affections. The exact procedure, as the system is now in use at the Battle
Creek Sanitarium, under the author's direction, may be thus briefly described:
Exercise. - Each of the following movements
is taken with resistance in both directions.
1. Arms forward stretch, sidewise moving, returning.
2. Arms downward stretch, forearm flexion and extension.
3. Arms downward stretch, forward upward moving,
4. Fingers flexed, knuckles in contact at umbilicus,
- arms raising to vertex, returning.
5. Arms downward stretch, forward raising to upward
6. Trunk forward bending; resistance, (a) hands
sternum and loins; (b) hand at upper spine.
7. Trunk rotating; resistance (a) left hand in front
of patient's right shoulder, right hand behind patient's left shoulder;
8. Lateral trunk flexion; resistance, attendant
in front of patient, (a) right hand under patient's left arm, left hand
on patient's right hip; (b) reverse.
9. Same as 1, except fist firmly clenched.
10. Same as 2, except palmar surface is turned out,
and fist firmly closed during exercise
11. Arm circumduction, one arm at a time.
12. Arms backward raising - trunk must not bend
13. Knee raising, body balanced by support of opposite
14. Leg forward and backward raising.
15. Leg backward flexing; hand support.
16. Leg outward raising.
17. Arms rotating, extreme degree.
18. Wrist flexion and extension.
19. Foot flexion and extension.
RULES PERTAINING TO EXERCISE
1. Movements must be slow and uniform.
2. Follow each movement by an interval of rest.
3. Movements of' the same limb or group of muscles
should not be repeated twice in succession.
4. Movements should be immediately interrupted if
any, of the following symptoms appear, and the patient must be watched
closely to avoid the development of these signs, which indicate exhaustion:
(1) Accelerated breathing.
(2) Marked movements of the nares in breathing.
(3) Slight drawing of the corners of the mouth.
(4) Pallor or duskiness of the cheeks or lips.
(5) Palpitation of the heart.
If any of. the above signs should appear in the
midst of the movement, the exercise must be instantly :suspended, the limbs
being carefully placed in a state of rest.
5. The patient should not be allowed to hold the
breath. To prevent this the patient should count in a whisper from 1 to
8 while the movement is being executed,. or during each half of it.
6. Constriction of the limbs or any other portion
of the body whereby the blood-vessels may be compressed, must be carefully
7. The force of the movement must be very carefully
graduated to the strength of the patient. It is sometimes necessary to
employ only the very gentlest resistance. Patients who are bedridden, and
those who are very feeble cannot at first take all the movements, but must
take only such as are adapted to their condition or strength.
8. Examination of the heart, should be very carefully
made in every case before beginning treatment. In cases of emphysema, asthma,
and in obstruction of the aortic orifice, great care must be taken, especially
with the arm-raising movement, to avoid producing syncope, on account of
the obstruction of the pulmonary circulation. The same rule applies to
any condition in which the respiratory area is diminished, as in pleurisy
with effusion, consolidation of the lung, dropsy of the chest, pyothorax,
9. In these cases the movements must be executed
very slowly, so as to give time for the distribution of the blood. They
may have to be taken while the patient is lying down. The right side of
the heart being overloaded in these cases, the arm movement should not
at first extend above the level of the shoulders, unless the patient is
reclining, as the extension of the right heart would be increased by giving
the blood the down grade in the arteries.
10. Special attention should be given also to the
patient's regimen and diet by enforcing an aseptic dietary. Such exercise
as graduated mountain climbing is too severe for patients requiring this
treatment. It is only adapted to cases which have made considerable advancement
toward a cure. The object of the method is not to strengthen the muscles,
but to regulate the circulation.
11. The patient may, to some extent, administer
the exercise himself, by executing the various movements, producing the
resistance by hardening the muscle, as though working against the resistant
Baths. - The purpose of the baths is to dilate
the peripheral, and stimulate the arterial circulation.
The bath contains graduated quantities of chloride
of sodium and chloride of calcium, as follows:
Chloride of sodium 1 %, chloride
of calcium 2 %
Chloride of sodium 2%, chloride
of calcium 3%.
Chloride of sodium 3%, chloride
of calcium 5%.
Effervescence in three grades is produced by adding sodium bicarbonate
and hydrochloric acid in varying quantities as follows:
Sodium bicarbonate ½
lb., hydrochloric acid (25%) 3/4 lb.
Sodium bicarbonate l lb.,
hydrochloric acid (25 %) 1 1/2 lbs.
Sodium bicarbonate 2 lbs.,
hydrochloric acid (25%) 3 lbs
If a copper tub is used, one-fourth extra amount
of bicarbonate should be employed to protect the copper from corrosion.
In mixing the ingredients, first dissolve the bicarbonate
of soda in water in the tub. Then, for slow effervescence place the bottle
containing the acid, with stopper removed, at the bottom of the bath, laying
it down upon the bottom, and moving it around from time to time. The bath
will be ready in two or three hours. For rapid effervescence, invert the
bottle without removing the stopper, place the mouth of the bottle just
below the surface of the water, withdraw the stopper, and move the bottle
about over the surface of the bath, so as to distribute a uniform layer
of acid. By this means the bath is prepared in five minutes. The temperature
of the bath should be 92 0F.
Generally the bath should be taken only two or three
days in succession, one day's respite being allowed. With stronger persons
four or five successive baths may be given. The chloride of calcium and
the chloride of sodium increase the skin excitation. The effect of the
bath should be to slow the pulse, to lessen the area of cardiac dullness,
and to increase the force of the pulse. Examination of the cardiac area
should be made before the bath, and marked on the chart, a diagram being
preserved in each case. Sphygmographic tracing of the pulse should also
be made, the blood pressure being determined with the sphygmo-manometer.
Full directions for the use of the effervescent bath and other baths applicable
to cardiac cases will be found in the author's handbook of " Rational Hydrotherapy."1
1. The F. A. Davis Co., Philadelphia, Pa.