Bladder. Rheumatism. Lumbago. Stiff Neck. Gout.

AFFECTIONS OF THE BLADDER.
We have here to deal with two common conditions : the retention of the urine and the incontinence of the urine. Both have been successfully treated by massage. Before starting the treatment the bladder should be emptied naturally, or artificially if necessary. Massage the whole abdomen first and then use strokings, frictions and vibrations locally. In many nervous women especially at the climacteric period we find the symptom of frequent desire to urinate. In such cases massage is an excellent remedy, vibrations being especially effective. The bladder should never be treated mechanically except on the order of a physician, as there are many conditions in which massage may do a great deal of harm instead of good.

RHEUMATISM.
The active movements, as well as hacking and beating of the affected parts, are of great benefit in cases of rheumatism. In severe attacks the treatment should be applied twice daily. The patient must move his limbs freely instead of keeping them inactive. Begin with general massage around and over the affected part; continue with local massage on the diseased muscle or joint and finish the treatment with a few movements that give effect upon the circulation and respiration. The operator should study his case carefully and by passive and active movements of the affected part try to localize the rheumatic deposits. How important this is will be clearly illustrated to the reader in the following case: A gentleman was sent to me for massage for a "rheumatic shoulder" ; he had been treated for some time with massage applied locally, i. e., right over and close to the joint. The result had been unsatisfactory and he had no faith in the treatment. The joint was carefully examined and was found all right. He could raise the arm and he could rotate it without pain or difficulty, but when I told him to throw the arm downward and backward, I then saw that his trouble was located in the latissimus dorsi. This muscle was then carefully treated and with very satisfactory result. He at first ridiculed the idea of curing an affected shoulder by treating the lower part of the back, but is to-day a very enthusiastic believer in scientific massage.

LUMBAGO.
The patient should lie on his face with the abdomen supported by pillows. The operator should perform firm strokings with both hands over the lumbar region, from the spinal column toward the sides. In many cases it is well to give massage to the whole back and the glutei, as previously described. The treatment must be given twice or three times daily. It generally takes from two to five days to conquer the trouble. To prevent lumbago the following movements may be used:
1. St. bending of body.
2. L. raising of body.
3. S. bending of trunk.
4. S, raising of body.

STIFF NECK.
This affection is somewhat similar to lumbago and has been treated with like success. Begin with massage over the sterno-cleido-mastoid and continue with pressing and shaking. A few (in the beginning passive) movements will finish the treatment. Though at first painful, the patient will in a few days be relieved by the treatment. The following movements may be used:
1. S. or susp. bending of head.
2. S. turning of head.
3. S. rotation of head.

GOUT.
Between the attacks massage is often prescribed, especially for podagra. The treatment must be given for general activity of the muscles.
1. St. bending of knees.
2. St. bending backward (back supported).
3. L. flexion and extension of legs.
4. S. turning of body.
5. S. rotation of arms.
6. Flexion and extension of feet.
7. S. raising of body.
8. Beating of sacrum.
9. Massage of stomach.
10. St. percussion of back.
The general massage is always of benefit and firm friction on the sole of the foot is very effective in cases of podagra.