Bronchitis, Nervous Asthma. Colds. Diseases Of The Heart.

BRONCHITIS, NERVOUS ASTHMA, ETC., are frequently treated by massage, generally in the form of strokings of the entire chest, the patient inspiring deeply at the same time. The seance must not exceed twenty minutes.

COLDS.
So many persons suffer with recurrent colds in our changeable climate that we deem it well to pay some attention to the matter. A cold is an inflammation of the mucons membrane lining the upper respiratory passages. One region is generally more affected than the others. A cold begins with a congestion and its principal causes are : (1) "chilling the skin in a person whose skin is sensitive and tender to the changes of temperature, causing a contraction of the superficial blood-vessels, and driving an excess of blood to the deeper structures of the body; (2) local irritation to an already congested respiratory tract, by the inhalation of polluted air, and air containing irritating substances such as dust, smoke, gases, etc."

Colds are most common in winter time, not on account of the cold weather but because at that time we breathe the most impure air, everything often being shut up in order to save fuel. To prevent colds we must consequently breathe pure air and keep the function of the skin normal. This latter is best accomplished by proper daily bathing, massage and exercise. For the younger person we think nothing better than a cool sponge off with brisk friction every morning in a room of a temperature never less than 70° F. For older persons and for those not so very robust we recommend the hot-cold spray bath. The person sits in a tub with warm water up to the hips ; now spray the spine neck and chest with cool water, starting with a temperature of 85° F. and gradually in the course of a week or two, lowering it down to 500 F. Half a minute is enough at first. A strong self-massage with a rough rubber sponge or wash cloth is advisable, but the patient should always rub himself per fectly dry with a rough towel. If weak this must of course be done by an attendant. If the patient has the opportunity of scientific massage for half an hour each morning so much the better; if not we must teach him some few effective movements to be practised every morning after his bath. The following are good:
1. Standing rotation of arms.
2. Ostrom's combined resp. movement.
3. St. bending of the body forward and backward.
4. Deep knee bend.
5. St. bending of the body sideways.
We do not wish the reader to lose sight of the fact that there are certain remedies which, if taken in the very incipiency of a cold, are really specific in their effect.

DISEASES OF THE HEART.
Massage and movements are indicated in affections of the heart caused by nervous debility, anemia, diseases of the stomach, etc. The movements mostly used are : Sitting, raising of the chest, with shaking, to pro duce strong respiration; Rotation of the extremities, to assist the heart in its action; Rotation and turning of the body, to give effect upon the great venous system; Centripetal stroking, to remove the subcutaneous effusions. In organic diseases of the heart, movements are recommended by some of the most eminent physicians. They apply movements to support the heart in its action, generally using such as will increase the circulation in the distant parts of the body. Within the last few years a new system of exercises for heart-affections has been developed by Dr. August Schott, of Bad Nauheim, Germany. The results have at times been remarkable. He employs the effervescent Nauheim water, as a rule, daily, and directs a series of resistive exercises (original Swedish movements) to be given daily, or every other day if the patient is quite weak. The general massage - gently applied - is too often lost sight of as a most excellent preparation for this particular movement cure. All the movements are duplicated-active, and the resistance should be so applied as not to interfere with the circulation - preferably, when possible, with the palmar surface of the hand. Every movement should be performed slowly, and the operator should watch his patient most carefully. At first the seance should last but ten minutes, to be gradually and carefully increased to thirty minutes. A rest should be allowed after each movement, and, contrary to the Swedish methods of treatment, no exercise is to be applied more than once in each series.

The operator should carefully guard against the following symptoms:
1. Intermission of the pulse.
2. Weakness of the pulse.
3. Increased respiration.
4. Palpitation of the heart.
5. Dilatation of the nostrils.
6. General feeling of discomfort.
When any of the above-mentioned symptoms appear allow a few minutes' rest; or, if necessary, stop the treatment for the day. It is customary to take the pulse and respiration before starting, during the middle of the seance, and at its close. A careful record should be kept for the reference of the attending physician.
The principal Schott exercises are:
1. Separating and closing of arms.
2. Flexion and extension of each arm.
3. Raising of the arms upward.
4. Rotation of the arms.
5. Pronation and supination of the forearm.
6. Flexion and extension of the hand.
7. Flexion and extension of the ringers.
8. Abduction and adduction of the fingers.
9. St. bending of the body forward and backward.
10. S. bending of the body sideways.
11. S. rotation of the body.
12. Same as 1, with clenched fist.
13. Same as 2, with clenched fist.
14. St. arms extended forward and backward.
15. L. flexion and extension of the leg.
16. L. flexion and extension of the foot.
17. L. separation and closing of the thighs or legs.
18. St. leg extended forward and backward.

Careful operators are sometimes requested to apply treatment locally; then use massage of the chest, as previously described, with hacking in small circles over the cardiac region. Palmar vibrations are also used. In the European institutes of medical gymnastics it is quite common to see the vibrations applied over the heart. The operator then places his arm upon the artificial vibrator and the wave-like movements are transferred to the cardiac region through the semi-flexed and abducted fingers. Except when especially requested by a physician, however, this local application is seldom used. Gentle respiratory movements should always form the conclusion of the treatment, and an hour's rest should be rigidly insisted upon.