If it is desirable to give special attention or an
extra share of manipulation to any part of the spinal region, this is
done as the physician may have ordered, and the whole process is
completed by downward friction over the spine, given vigorously and as
rapidly as possible.
The chest is the next region to be handled, the patient turning from the
prone to the supine position. In women the breasts are usually best left
untouched unless special conditions demand their treatment.
The last and perhaps most important part of the process of general
massage is the rubbing of the abdomen. Particular care is needed to
secure complete relaxation, as nervous patients and, still more,
hysterical patients are apt to present extreme rigidity of the abdominal
muscles. The head is raised by pillows, the knees are slightly flexed
and sometimes supported by a folded pillow also. With this position the
rigidity generally yields to gentle persistence, at any rate after a
few treatments. If it does not do so, a lateral decubitus may be tried,
a position in which the intestinal regions may be very thoroughly
treated, and in which, if there be gastric dilatation, the stomach-walls
can be best reached.
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