General Weakness, Anemia, Hysteria, Chorea

GENERAL WEAKNESS.
Apply general massage. Follow with passive flexions and extensions, rotations and pressings. Finally give percussion of the back, if the patient's strength permits. The first treatments should last from twenty to thirty-five minutes, gradually increasing to an hour at the end of the first week. Daily treatments are necessary. Under this heading come most of the affections or rather conditions treated by general massage; for instance, when a patient is convalescent after fevers (typhoid, scarlatina), after operations, when the body is emaciated, in many conditions of nervous disorders, and in general when we propose the treatment as a tonic instead of outdoor exercise.

ANEMIA.
For this disease some authors recommend general massage of the whole body, others recommend a complete series of movements. A series of well selected movements in connection with the general massage will perhaps be the most effective agent in renewing the blood. The treatment must be only by passive movements, and such as will aid the digestion, the circulation and the respiration. When the patient is very feeble, use only the general massage, gradually commencing with the movements as the strength increases. All exercises should be passive, so as not to overtax the patient. The following series, recommended by Professor Hartelius, of Stockholm, Sweden, has frequently been used with success:
1.S. rotation of the arms.
2.Half L. rotation of feet.
3.Massage of abdomen.
4.S. rotation of arms.
5.S. rotation of body.
6.Half L. flexion and extension of legs.
7.St. percussion of back.
(1. S. means sitting; St., standing; L., lying; Kn., kneeling; Sp., suspending.
2.Whenever the expression "percussion" is used, the author means hacking.)

The first movement is for respiration, extending the chest. The air is inspired more freely and a greater quantity of oxygen brought in contact with the blood. Eight to twelve times. The second carries the blood to the feet, which are generally cold; the third aids digestion and increases the appetite ; the fourth, see I ; the fifth affects the great venous system ; the sixth increases circulation in the lower extremities ; the seventh has a refreshing action on the whole system. The movements are scientifically arranged to remove the tired feeling, the loss of appetite, the cold hands and feet, the backache, and all symptoms we find in an anemic patient. If there be any abdominal affections, special attention must be paid to them in the selection of the movements.

HYSTERIA.
For hysteria we use such manipulations as will act directly upon the peripheric nervous system. The general massage, followed by a few rotary movements of the extremities, is to be recommended.

CHOREA.
If the disease has advanced so far that the child has no control whatever over the limbs, place him on a couch or bed, one operator standing at the head, holding the arms, another standing at the feet, grasping the lower extremities. Begin with gentle stroking with the palm of the hand over the extremities and the chest, gradually increasing the strength ; then turn the patient over on his face, and continue the firm stroking over the back and neck. The full treatment should last an hour, and be repeated daily four or five times. (Blache.) As soon as improvement is visible, begin with certain passive movements, such as flexion and extension of the extremities, separating and closing of the knees, bending of the head, depression and elevation of the arms. The patient is soon able to take duplicated active movements, and is finally instructed in general active movements or calisthenics, the operator keeping exact time. Strong, persistent treatment every day, with special attention to the duplicated active movements, will yield good results.