In this case it
would be well to see that the rubbing was not being made too severe.
Very rarely I find a patient to whom all massage is so disagreeable or
produces such annoying nervousness as to make manipulation impossible;
sometimes, though very rarely, massage, especially frictional movements,
causes sexual excitement when applied in the neighborhood of the genital
organs, or even on the buttocks and lower spine, and this may occur in
either sane or insane patients: if the rubber observe any signs of this,
it will of course be best to avoid handling the areas which are thus
sensitive.
Another complaint sometimes made is of chilliness after treatment, and
especially of cold feet. If this is not lessened after a few days, the
lower extremities may be rubbed last instead of first, or as is now and
then useful, the whole order of massage may be changed so as to begin
with the abdomen, chest, and upper extremities and conclude with the
back and legs.[17]
Beginning with half an hour and gradually increasing to about an hour (a
little more for very large or very fat people,--a little less for the
small or thin) the daily massage is kept up through at least six weeks,
and then if everything seems to be going along well, I direct the rubber
or nurse to spend half of the hour in exercising the limbs as a
preparation for walking.
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