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Mitchell, S. Weir (Silas Weir), 1829-1914

"Fat and Blood An Essay on the Treatment of Certain Forms of Neurasthenia and Hysteria"


First, as to massage: the operator must direct his efforts primarily to
the relaxation of the tense muscles, secondarily to the strengthening of
the opponent groups, this last being of special importance where actual
contraction has taken place. He should make frequent attempts by
stretching the rigid groups to overcome the spasm, which in large
muscle-masses may be done by grasping with both hands, taking care not
to pinch, and pulling the hands apart in the line of the muscle's long
axis, thus stretching the muscles. Pressure will sometimes accomplish
the same end, and it will be found in certain cases that by kneading
_during action_,--that is, while the patient endeavors to produce
voluntary contraction,--the result will be better. Except in the most
spastic states, a certain degree of relaxation is possible by effort,
though not without practice, and this has to be constantly inculcated
and encouraged. After a period varying in length according to the case,
lessons in co-ordinating movements are begun. It is best for the
patient's encouragement to start with the least affected muscles, so
that, seeing the good results, he may be stimulated to persistent
effort.


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